摘要
目的对他汀类降脂药物与其他药物联合应用所致的药物不良反应进行分析,为临床合理用药提供针对性指导。方法对2016年3月至2017年6月我院使用他汀类降脂药物或联用其他药物致药物不良反应的94例患者的临床资料进行回顾性分析。结果在94例发生药物不良反应的患者中,肌肉毒性反应占比最高(35.11%),其次为肝毒性及消化系统不良反应(分别占25.53%与19.15%,其中横纹肌溶解占比为25.53%)。使用的他汀类降脂药物主要有辛伐他汀、阿托伐他汀、洛伐他汀、普伐他汀、氟伐他汀与瑞舒伐他汀。其中辛伐他汀致药物不良反应占比高达41.49%;其次为阿托伐他汀占29.79%。他汀类降脂药物与抗心肌缺血药或降压药、抗凝药或抗血小板药、贝特类调脂药物、抗病毒药、抗菌药、抗糖尿病药、注射剂或中成药等药物联合应用均可致不良反应发生,其中与抗心肌缺血药或降压药联用最易发生不良反应(27.66%);其次为与抗凝药/抗血小板药或与贝特类调脂药物联合应用(分别占20.21%、17.02%)。男性患者发生药物不良反应的比例(56.38%)略高于女性(43.62%);70~79岁患者发生药物不良反应的概率高于其他年龄段患者。结论以辛伐他汀、阿托伐他汀为主的他汀类降脂药物与抗心肌缺血、降压、抗凝、抗血小板等药物联合应用时发生不良反应的风险较高,主要表现为肝毒性与肌肉毒性,患者年龄是重要的影响因素。
Objective To analyze the adverse drug reactions caused by the combination of statins and other drugs,so as to provide guidance for rational use of drugs in clinical practice. Methods Methods the clinical data of 94 patients who took statin lipid-lowering drugs combined with other drugs in our hospital from March 2016 to June 2017 were retrospectively analyzed.Results The highest ratio of muscle toxicity（35. 11%） was found in 94 patients with adverse drug reactions. Hepatotoxicity and adverse reaction of digestive system were25. 53% and 19. 15%. The ratio of rhabdomyolysis was 25. 53%. Statins include simvastatin,atorvastatin,lovastatin,pravastatin,fluvastatin,and rosuvastatin. The ratio of Simvastatin to drug adverse reaction was41. 49%,and the second was atorvastatin 29. 79%. Statins combined with anti myocardial ischemia drugs or antihypertensive drugs,anticoagulants or antiplatelet agents,Bette lipid lowering drugs,antiviral drugs,antibacterial agents,antidiabetic drugs,injections or proprietary Chinese medicines,can cause adverse reactions. The combination of anti myocardial ischemia drugs or antihypertensive drugs is the most common adverse reaction（27. 66%）,followed by anticoagulant/antiplatelet drugs or combined with beats lipid regulating drugs（20. 21% and 17. 02%）. The incidence of adverse drug reactions in male patients（ 56. 38%） is slightly higher than that in females（43. 62%）,and the probability of adverse drug reactions in 70-79 years old patients is higher than that in other age groups. Conclusion Simvastatin and atorvastatin represent a high risk of adverse reactions when combined with anti myocardial ischemia,antihypertensive,anticoagulation and antiplatelet drugs. The main manifestations are hepatotoxicity and muscle toxicity,and the age of the patients is an important factor.
作者
杨珍
马晓芝
马祎
杜占亮
YANG Zhen 1, MA Xiaozhi 2 , MA Yi 1, DU Zhanliang 1(1 National Hospital of Linxia city in Gansu Province, Linxia 731100, China;2 Linxia State Center for disease prevention and control in Gansu Province, Linxia 731100, Chin)
出处
《内科》
2018年第2期181-184,共4页
Internal Medicine
