506例药源性高血糖不良反应报告统计分析

Statistical Analysis of 506 Cases with Adverse Reaction of Drug-Induced Hyperglycemia

目的:了解药源性高血糖人群、用药等数据信息,探索严重药源性高血糖的影响因素,为临床安全用药提供依据。方法:收集2017~2021年国家药品不良反应监测系统浙江省平台中药源性高血糖的相关报告506例,对患者基本信息、不良反应涉及药物、药品剂型和给药途径、不良反应结果等信息进行统计分析。采用Logistic回归对药源性高血糖严重报告进行年龄、既往是否有血糖异常史等多因素分析。结果:药源性高血糖患者年龄多分布在45岁以上(占87.5%);涉及药品品种以代谢及内分泌系统用药为主,最常见的是注射用甲泼尼龙琥珀酸钠;静脉给药方式不良反应潜伏时间短于口服给药方式;既往有血糖异常史患者伴随不良反应表现少于既往无血糖异常史患者。Logistic回归分析表明45~64岁和65岁及以上是药源性高血糖严重报告的危险因素(OR>1,P<0.05);既往有血糖异常史是保护因素。结论:临床应重视非降糖药引起的药源性高血糖,尤其是中老年人、既往无血糖异常史者,应定期监测血糖变化情况,确保临床用药的安全性。

Objective:To understand data of population and drug usage regarding drug-induced hyperglycemia,to explore the effect factors of severe drug-induced hyperglycemia,so as to provide reference for safe drug use in the clinic.Methods:506 cases with adverse reaction of drug-induced hyperglycemia reported from 2017 to 2021were retrieved in the National Drug Adverse Reaction Monitoring System for Zhejiang province and a statistical analysis was performed on patients’basic information,adverse reactions involving drugs,drug dosage forms,route of administration,and results of adverse reactions.Age and history of pathoglycemia were analyzed in the reports of severe drug-induced hyperglycemia by Logistic regression.Results:The majority of patients with drug-induced hyperglycemia were over 45 years old(87.5%);drug involved mainly are consisted of metabolic and endocrine drugs with the most common one as methylprednisolone sodium succinate;the latent period for intravenous is shorter than oral;and patients with a previous history of pathoglycemia showed less accompanying adverse reactions than patients with no previous history of pathoglycemia.Logistic regression analysis indicated that 45~64 and above 65 years were the risk factors for severe drug-induced hyperglycemia(OR>1,P<0.05);a history of pathoglycemia was a protective factor.Conclusion:Clinical attention should be paid to the drug-induced hyperglycemia caused by non-hypoglycemic drugs,especially in the middle-aged and elderly and those with no previous history of pathoglycemia.The blood glucose changes should be monitored regularly to ensure the safety of clinical medication.