北京市92例药物引起心电图QT间期延长的不良反应分析
Analysis on 92 Cases of Adverse Reactions of Drug-Induced QT Interval Prolongation on Electrocardiogram in Beijing
孙坤 1林京玉 2谢吉科 1唐婧 1毛乾泰 1艾超1
作者信息
- 1. 清华大学附属北京清华长庚医院/清华大学临床医学院药学部,北京 102218
- 2. 北京市药品不良反应监测中心药品监测科,北京 100054
- 折叠
摘要
目的:了解北京市上报的药物引起心电图QT间期延长的不良反应报告,探讨药品不良反应(ADR)发生规律及特点,为临床安全用药提供参考依据.方法:收集 2018-2022 年北京市各机构上报的 92 例QT间期延长的ADR报告,对ADR类型、患者性别和年龄、原患疾病和既往不良反应史、涉及药品的药理分类、药品性质、药物剂型、临床转归等进行分析.结果:92 例QT间期延长的ADR报告中,女性患者51 例(占55.43%),男性患者41 例(占44.57%);≥65 岁患者最多,共41 例(占44.57%).涉及药品 100 例次,其中以抗感染药物(44 例次)、抗精神病药(28 例次)、心血管系统用药(10 例次)为主;ADR例次数排序居前 3 位的药品为莫西沙星(32 例次)、氨磺必利(15 例次)、胺碘酮(7 例次);有口服及注射剂型的药品共 13 种,其中静脉剂型导致的ADR 45 例次,口服剂型导致的ADR 13 例次.ADR转归方面,痊愈和好转的有 79 例(占 85.87%).结论:在注射抗感染药物、口服抗精神病药、口服心血管系统用药、有QT间期延长不良反应的药物联合应用时,尤其是老年人、女性、本身存在QT间期延长者,要重点关注患者心电图情况和临床症状体征,必要时采用信息化预警手段,通过优化治疗方案,防止QT间期延长的发生及进展,保障患者用药安全.
Abstract
OBJECTIVE:To investigate the adverse drug reaction(ADR)reports of QT interval prolongation in ECG in Beijing,and to probe into the rules and characteristics of ADR,so as to provide reference for clinical safe medication.METHODS:A total of 92 cases of ADR of QT interval prolongation reported by institutions in Beijing from 2018 to 2022 were collected and analyzed in terms of types of ADR,patients'genders and ages,primary diseases and adverse reaction history,pharmacological classifications,drug properties,dosage forms and clinical outcomes.RESULTS:Among the 92 ADR reports of QT interval prolongation,51 cases were female patients(55.43%)and 41 cases were male patients(44.57%);the largest number of patients were≥65 years old,with 41 cases(44.57%).A total of 100 times of medicine were enrolled,which were dominated by anti-infective drugs(44 cases),antipsychotic drugs(28 cases)and cardiovascular drugs(10 cases);the top 3 drugs ranked by ADR cases were moxifloxacin(32 cases),amisulpride(15 cases)and amiodarone(7 cases);there were 13 kinds of drugs in both oral and injectable forms,with 45 cases of ADR were caused by intravenous dosage forms and 13 caused by oral dosage forms.In terms of ADR outcomes,79 cases(85.87%)were recovered and improved.CONCLUSIONS:In the combined application of injection of anti-infective drugs,oral administration of antipsychotic drugs,oral administration of cardiovascular drugs and drugs with adverse drug reactions of QT interval prolongation,especially for the elderly,females and those who have QT interval prolongation,it is necessary to pay attention to patients'ECG conditions and clinical signs and symptoms,and use informative early warning measure if necessary,to prevent the occurrence and progress of QT interval prolongation and to ensure medication safety by optimizing the therapeutic scheme.
关键词
心电图QT间期延长/药品不良反应/合理用药Key words
QT interval prolongation in ECG/Drug adverse reactions/Rational medication引用本文复制引用
基金项目
2022年北京药学会临床药学研究项目(LCYX-2022-18)
出版年
2024
国家科技期刊平台
NSTL
万方数据