223例药品不良反应分析

目的了解某院药品不良反应（ADR）的发生情况、探讨ADR发生的易感因素，为更好地预防ADR的发生、减少用药风险提供参考。方法收集该院2011年1月1日-12月31日临床上报的223例ADR报告，对患者年龄、引发ADR的药品种类及给药途径、ADR累及器官或系统等进行分析。结果223例 ADR患者，静脉滴注给药 211例（94.62%），静脉注射3例，肌内注射2例，口服给药7例。74.44%的ADR发生在用药1~30 min内，其中39例（17.49%）发生在用药后1~4 min内，45例（20.18%）发生在用药后5~9 min内，80例（35.87%）发生在用药后15~29 min内。在ADR累及器官或系统损害中，以皮肤及附件损伤最为常见（93例），其次为胃肠系统（62例）和全身性损害（45例）等；以累及单一器官或系统损害最为常见（184例，82.51%）。123例（55.16％）ADR是由抗菌药物引起，60例（26.91%）是由中药注射剂引起；ADR发生率居前10位的药物包括7种抗菌药物、3种中药注射剂，其中乳酸左氧氟沙星氯化钠注射液引起的ADR居各药物首位（23例，10.31%）。结论ADR的发生与多方面因素有关，临床应加强ADR报告与监测工作力度，促进抗菌药物和中药注射剂临床合理应用，从而降低ADR发生率。

Report of 223 cases of adverse drug reaction

Objective To investigate the incidence of adverse drug reaction (ADR) in patients in a hospital, and evaluate ADR related factors, so as to provide references for the prevention of ADR and reducing of risk factors in drug use. Methods223 clinically reported ADR cases were collected from January 1, 2011 to December 31, 2011, patients' age, types and administration routes of drugs relating to ADR, and ADR involved organs and systems were analyzed.ResultsOf 223 patients with ADR, 211（94.62%）received intravenous drip， 3 received intravenous injection， 2 received intramuscular injection，and 7 received oral administration. ADR mainly occurred within 1-30 minutes after taking the medicines， 39（17.49%）occurred within 1-4 minutes，45（20.18%）within 5-9 minutes，80（35.87%）within 15-29 minutes. Of organ or system involved by ADR, skin and its appendage damages were common (93 cases),followed by gastrointestinal tract (62 cases)and systemic damage (45 cases); single organ and systemic damage were most common (184 cases,82.51%). 123 cases (55.16%) of ADR were caused by antimicrobial use, 60 cases (26.91%) were induced by Chinese medicine injection; Of top 10 ADR inducing medicines,7 were antimicrobial agents and 3 were traditional Chinese medicine injections, levofloxacin lactate and sodium chloride injection ranked first(23 cases,10.31%).ConclusionThe occurrence of ADR is related to multiple factors, reporting and surveillance of ADR should be strengthened, the use of antimicrobial agents and traditional Chinese medicine should be rational, thereby reduce the occurrence of ADR.