他汀类药物不良反应的临床分析

Adverse Reactions Induced by Statins:A Clinical Analysis

目的通过分析他汀类药物不良反应报告,为合理使用他汀类药物及不良反应预防提供依据。方法收集从2011-2021年某医院的他汀类药物不良反应报告,依据帕累托分类原则,统计他汀类药物不良反应的类型以及患者的基本情况,分析可能的影响因素以及结局等。结果共收集147例他汀类药物的不良反应报告,他汀类药物不良反应发生人群中55岁以上患者占73.47%;不同年龄合并用药数量:65岁以上为14.29±3.77种,55~65岁为10.50±2.31种;报告中肝损伤占比最高(70.07%),其他还有肌肉、皮肤和神经系统等方面的不良反应;不良反应发生的中位时间为4d;引起不良反应的主要药物为阿托伐他汀40mg·d^(-1)、阿托伐他汀20mg·d^(-1)以及瑞舒伐他汀10mg·d^(-1);多数患者持续时间在9d以内(72.79%);63例患者痊愈(42.86%),71例患者好转(48.30%)。结论使用他汀类药物时,对于55岁以上人群,应尽量精简药物使用种类,避免增加剂量的强化降脂方案,使用4d左右时应注意监测肝功能指标以及其他不良反应,如有发生应及时停药治疗,多数可好转或痊愈。

Objective To provide data for rational use of statins and prevention of adverse drug reactions(ADR).Methods Reports of ADR of statins from 2011 to 2021 were collected.According to the Pareto principle,the types of ADR of statins,basic data of patients,possible influencing factors and outcomes were analyzed.Results A total of 147 ADR of statins were reported and 73.47%of the patients were over 55.The number of combined drugs was 14.29±3.77 for patients over 65,and 10.50±2.31 for those ages 55 to 65.The percentage of liver damage was the highest(70.07%),with other adverse effects manifested in the muscle,skin and nervous system.The median duration of ADR was 4 days.Drugs that were chiefly responsible for these ADR were atorvastatin 40 mg·d^(-1),atorvastatin 20 mg·d^(-1),and rosuvastatin 10 mg·d^(-1).The duration of ADR was less than 9 d(72.79%)in most of the patients,among who 63 recovered(42.86%)and 71 improved(48.30%).Conclusion When statins are used in patients over 55 years old,clinicians should minimize the drug regimen and avoid prescribing intensive lipid-lowering satins.Liver function indicators and other ADR should be monitored four days into the medication.Statins should be withdrawn in case of ADR.