1861例抗糖尿病药物所致不良反应文献分析

目的:探讨我国抗糖尿病药物所致不良反应发生的一般规律及有关特点,并分析相关因素,为临床用药提供参考。方法:对国内公开报道的1861例抗糖尿病药物所致不良反应文献进行分类统计与分析。结果:1861例抗糖尿病药物所致ADR病例中,男女比例基本相当,≥60岁的病例占已知年龄病例数的76.3%,48.8%的病例存在不合理用药,50.2%的病例联合用药;不良反应病例占较高比例的是格列本脲(40.3%),其次为胰岛素、消渴丸、苯乙双胍等;ADR临床表现复杂多样,以低血糖反应为主(62.9%),其次是变态反应(14.0%)及乳酸酸中毒(11.0%);多数病例治愈或好转(91.4%),严重者可致残或致死(8.6%),致残或致死病例占较高比例的是苯乙双胍(35.3%),其次为格列本脲、消渴丸、二甲双胍等。结论:使用抗糖尿病药物时须慎重考虑患者年龄、用法用量、药物品种等相关因素,做到合理用药,减少不良反应的发生。

Literature analysis of 1861 adverse drug reactions caused by hypoglycemic drugs

Objective： To discuss the general rules and characteristics of adverse drug reactions induced by hypoglycemic drugs, analyze the relevant factors, provide reference for rational clinical use of hypoglycemic drugs. Methods： A total of 1861 cases of adverse drug reactions induced by hypoglycemic drugs were statistically analyzed. Results： The ratio of male to female was approximately 1：1. The cases above 60 years old accounted for 76.3% of all the cases. The proportion of irrational drug use and drug combination accounted for 48.8% and 50.2%. The adverse reactions induced by glyburide contributed to higher ratio （40.3%）, and followed by insulin, Xiaoke pill and phenformin. Clinical manifestations of ADRs were various, including hypoglycemia （62.9%）, allergic reactions （14.0%） and lactate acidosis （11.0%）. Most cases could be cured or improved （91.4%）. Severe reactions could cause mutilation or death （8.6%）, of which the ratio of mutilation or death induced by phenformin was higher （35.3%）, and then was glyburide, Xiaoke pill and diformin. Conclusion： Several factors should be taken into consideration to avoid the occurrence of ADRs including age, dosage, drug varieties and so on.