摘要
目的对血必净注射液致重症过敏反应(SA)的临床特征及危险因素进行分析,为临床提供安全用药数据。方法采用回顾性研究方法,收集2016年5月至2018年2月我院使用血必净注射液患者的数据,根据SA诊断标准分为SA组和非SA组,比较两组患者基础生理、原患疾病、合并用药,以及血必净注射液日给药剂量、溶媒种类、输液浓度、预处理等多种因素,分析SA的危险因素。结果 3 530例使用血必净注射液的患者中有113例发生SA,发生率为3. 20%,48. 67%发生在首次用药30 min内,经停药、吸氧、抗过敏等干预后,其过敏症状逐渐改善,最后均痊愈出院。单因素方差分析结果显示,两组患者年龄、入住ICU、原患疾病为重症脓毒症、多器官功能障碍综合征、合并用药种类数、合并中药注射剂、血管升压药、血必净注射液日给药剂量、输液浓度和预处理差异有统计学意义(P <0. 05),Logistic回归分析结果显示,预处理、输液浓度(> 80 ml/100 ml)、合并用药种类数(> 7种)、入住ICU、年龄(≤3岁、≥65岁)、合并中药注射剂、日给药剂量(> 210 ml)是血必净注射液致SA的独立危险因素。结论临床实践中应重点关注有独立危险因素的患者,保证血必净注射液临床安全用药。
Objective To investigate the clinical features and risk factors of serious anaphylaxis(SA)induced by Xuebijing injection.Methods A retrospective study was performed to collect data in patients receiving Xuebijing injection from May2016to February2018.Patients were divided into SA group and non-SA group according to diagnostic criteria of SA;the basic physiological situation,original disease,combined medication,and the daily dose,solvent type,infusion concentration and pretreatment of Xuebijing injection and other factors were compared between the two groups.The risk factors for SA were analyzed.Results There were113cases of SA,which accounted for3.20%in the3530patients who received Xuebijing injection,and48.67%of them occurred within30min after first medication.The allergy symptoms were improved after drug withdrawal,oxygen inhalation and anti-allergic interventions.Univariate analysis showed that risk factors for SA included the patient's age,admission to ICU,severe sepsis as the original disease,multiple organ dysfunction syndrome,the number of types of combined drugs,combination with traditional Chinese medicine injections,vasopressors,and the daily dose,infusion concentration and pretreatment of Xuebijing injection,and the differences between the two groups were statistically significant(P<0.05).Logistic analysis showed that the independent risk factors included pretreatment,infusion concentration(>80ml/100ml),the number of types of combined drugs(>7types),ICU admission,age(≤3years and≥65years),combination with traditional Chinese medicine injections and daily dose(>210ml).Conclusion Clinically practice attention should be paid to patients with independent risk factors to ensure the safe use of Xuebijing injection.
作者
王立丹
张晓燕
杜梅
李凤蕾
张媛媛
王伟美
WANG Li-dan;ZHANG Xiao-yan;DU Mei;LI Feng-lei;ZHANG Yuan-yuan;WANG Wei-mei(Department of Pharmacy,Harrison International Peace Hospital,Hengshui 053000,China)
出处
《实用药物与临床》
CAS
2018年第12期1420-1423,共4页
Practical Pharmacy and Clinical Remedies
基金
衡水市科技计划项目(15022)
