38例儿童万古霉素不良反应的Pareto最优分析

目的：分析儿童发生万古霉素不良反应（ADR）的一般特点及规律，为合理用药提供参考。方法：用Pareto最优分析，对2009-2015年湖南省儿童医院上报国家药品不良反应监测系统的38例万古霉素ADR报告进行整理，从患儿年龄、性别、用药后ADR发生时间、合并用药、ADR累及器官/系统及临床表现等方面进行统计分析。结果：发生万古霉素ADR的患儿中，男孩比例高于女孩（73.7% vs 26.3%）；患儿年龄集中在1个月~2岁（79.0%）；ADR发生时间主要在用药60 min以内（50.0%）和用药7 d后（21.1%）；有27例（71%）用3种及以上药物联合治疗；ADR主要临床表现为过敏反应（64.6%），主要累及皮肤及其附件。结论：临床医师、药师应了解儿童万古霉素ADR的特点和规律，加强其应用监测，以减少ADR的发生。

Pareto Optimal Analysis of 38 Cases of Adverse Reactions Induced by Vancomycin

Objective: To study characteristics of adverse drug reactions (ADR) induced by vancomycin to provide references for clinical rational use of the drugs. Methods: The Pareto optimal analysis was adopted to analyze 38 cases of ADRs that were reported from Hunan Children''s Hospital to the National Adverse Drug Reaction 2009.1 ~ 2015.12 in respect of the patient''s age, sex, time of occurrence of ADRs, combined medication, ADR types and clinical manifestations. Results: ADRs induced by Vancomycin in children, the proportion of boys was significantly higher than that of girls; 1mouth to 2 years old (79.0%) was the major age; Most cases occurred in 60 minutes (50.0%) and 7 days (21.1%). 27 patients (71.0%) were treated with more than three kinds of drugs. The clinical manifestations of ADR were allergic reaction (64.5%). Conclusion: Clinical doctors and pharmacists should understand the pattern and characteristics of ADRs induced by vancomycin, and strengthen monitoring of its use to reduce occurrence of ADRs.