皮肤药物不良反应(CADR)是临床用药中普遍存在的问题。本研究旨在探讨临床药物应用与CADR发生的相关性,为临床预防策略及合理用药提供依据。
分析2007年3月至2018年12月山东省第三医院858例患者的CADR特点。通过病例-非病例和多元logistic回归分析,研究了与常见皮肤症状有关的最重要药物及其对CADR的意义。
858例CADR患者共涉及266种药物。在十种最相关的药物中,主要是抗生素和草药注射,和营养支持药物,脱水穿心莲内酯钾钠琥珀酸注射液,发现头孢哌酮钠舒巴坦钠注射液在统计学上比其他药物不良反应(ADR)更容易发生CADR的2.1和1.45倍,分别。主要给药途径为静脉注射(63.16%),口服占25.19%。有747例ADR,71例严重不良反应,2个新的和严重的ADR,38例新的ADR。总的来说,100例CADR显示丙氨酸转氨酶异常,天冬氨酸转氨酶,和血清肌酐水平.严重CADR发生的预测因素包括过敏史和吸烟史,头孢哌酮钠,舒巴坦钠注射液,乳酸左氧氟沙星氯化钠注射液。
药物引起的CADR症状通常与其他ARD有关,主要是皮疹和瘙痒,通常伴随着一些医疗条件,尤其是肝肾损害.详细关注患者的原发疾病,过敏史,药物安全性可以帮助预防或逆转大多数患者的CADR。
Cutaneous adverse drug reaction (CADR) is a common problem in clinical medication. This study aimed to investigate the correlation between clinical drug application and CADR occurrence as evidence for preventive strategies and rational clinical drug use.
We analyzed the characteristics of CADRs of 858 patients admitted to Shandong Provincial Third Hospital from March 2007 to December 2018. The most significant drugs concerning the common skin symptoms and their significance to CADR were investigated by case-non-case and multiple logistic regression analyses.
A total of 266 drugs were involved in 858 cases of CADR. Among the ten most relevant medications, primarily antibiotics and herbal injections, and nutritional support drugs, potassium sodium dehydroandrographolide succinate injection, and cefoperazone sodium and sulbactam sodium injection were found to be 2.1 and 1.45 times statistically more prone to CADRs than to other adverse drug reactions (ADRs), respectively. The main route of administration was intravenous (63.16%), with oral administration accounting for 25.19%. There were 747 cases of ADR, 71 of severe ADR, 2 of new and severe ADRs, and 38 cases of new ADR. Overall, 100 cases of CADR exhibited abnormal alanine aminotransferase, aspartate aminotransferase, and serum creatinine levels. The predictive factors for severe CADR occurrence included allergy and smoking histories, cefoperazone sodium, sulbactam sodium injection, levofloxacin lactate and sodium chloride injection.
Drug-induced CADR symptoms are commonly associated with other ARDs, predominantly rashes and pruritus, and are often accompanied by some medical conditions, especially liver and kidney damage. Detailed attention to a patient\'s primary diseases, allergy history, and drug safety profile could help prevent or reverse CADR in most patients.