某院2013-2015年替加环素使用安全性分析
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篇名: 某院2013-2015年替加环素使用安全性分析
TITLE:
摘要: 目的:为替加环素的合理应用和警惕严重的不良反应的发生提供参考。方法:回顾某三级综合医院2013-2015年使用替加环素的50例患者,观察患者在使用替加环素注射液后症状、体征、实验室检验指标的变化,归纳和总结替加环素可能的不良反应、处理和转归。结果:50例患者中,共24例发生不良反应,其中诱发或加重凝血功能异常10例(41.67%)、肝功能损伤9例(37.50%)、恶心呕吐等胃肠道不适4例(16.67%)、全身多处皮肤红色皮疹伴瘙痒1例(4.17%)。消化系统不良反应均较轻,予抑酸、止吐等对症处理后均好转;影响较重的如肝功能损伤,在保肝、降酶等对症处理后仍不能好转。9例出现肝功能损伤患者,主要表现在总胆红素(TBIL)、直接胆红素(DBIL)、碱性磷酸酶(ALP)、乳酸脱氧酶(LDH)水平升高,其中8例为用药前即有肝功能损伤,用药后肝功能损伤加重;其中,3例为用药第10天出现,2例为用药第9天出现。10例用药前凝血功能异常病例,用药后出现凝血功能异常加剧,主要表现为部分凝血活酶时间(APTT)、凝血酶时间(TT)延长,国际标准化比值(INR)、凝血酶原时间(PT)、D-二聚体升高等;凝血功能异常加重多出现在使用替加环素后第2~22天,以第2~5天出现为主(70.00%)。结论:应用替加环素应高度警惕凝血功能异常、肝功能损伤等严重的不良反应,加强药品不良反应监测,以提高用药安全性。
ABSTRACT:

OBJECTIVE: To provide reference for rational application of tigecyclinet and alert to the occurrence of severe ADR. METHODS: Fifity patients receiving tigecycline in a level 3 general hospital during 2013-2015 were analyzed retrospectively to observe the change of symptom, sign and lab indexes after using Tigecyclinet injfection. Possible ADR of tigecycline, processing and outcomes were summarized. RESULTS: Among 50 patients, there were 24 cases of ADR, including 10 cases of inducing or aggravating blood coagulation abnormality (41.67%), 9 cases of liver function injury (37.50%), 4 cases of vomiting and other gastrointestinal discomfort (16.67%), 1 case of red erythra with itching (4.17%). ADR of digestive system were mild and recovered after symptomatic treatment as inhibiting acid, antiemetic. Severe ADR as Liver function injury could not be recovered after symptomatic treatment as protecting liver, reducing enzyme. Nine cases of liver function injury mainly manifested as the elevation of TBIL, DBIL, ALP, LDH; 8 of which suffered from liver function injury before medication and the symptom was aggravated after medication; liver function injury appeared in 3 cases on 10th day after medication and in 2 cases on 9th day after medication. Ten cases suffered from coagulation function disorder before medication and the symptom was aggravated after medication, which mainly manifested as the prolongation of APTT and TT and the elevation of INR, PT, D-dimer, etc. The coagulation function disorder was aggravated abnormally on 2nd-22th day after using tigecycline, mainly appearing on 2nd-5th day (70.00%). CONCLUSIONS: Great importance should be attached to severe ADR as coagulation function disorder, liver function injury when using tigecycline, in order to ensure the safety of drug use.


期刊: 2017年第28卷第8期
作者: 苏丹,徐姗,王君萍
AUTHORS: SU Dan,XU Shan,WANG Junping
关键字: 替加环素;不良反应;凝血异常;肝损伤;合理用药
KEYWORDS: Tigecycline; Adverse reactions; Blood coagulation disorder; Liver injury; Rational drug use
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