糖皮质激素的药物不良反应临床观察

目的通过观察分析糖皮质激素所产生的药物不良反应(ADR),以提高广大医务人员尤其是基层医务人员的认识,使之在临床工作不致滥用。方法收集整理近10年来在使用糖皮质激素过程中所观察到的39例ADR,进行分析总结。结果在39例ADR中,类库欣综合征5例(12.8%),消化性溃疡2例(5.10%),胃肠道出血4例(10.3%),糖耐量异常5例(12.8%),类固醇性糖尿病3例(7.70%),高血压5例(12.8%),肺结核复发或加重4例(10.3%),骨质疏松5例(12.8%),精神异常3例(7.70%),癫痫样发作1例(2.60%),股骨头坏死1例(2.60%),皮肤过敏1例(2.60%)。结论糖皮质激素在发挥治疗作用的同时,其ADR往往也很突出及严重,甚至可危及患者生命,因此,在使用皮质激素时,应充分考虑各种因素,权衡利弊,谨慎使用。

Clinical Observation of Adverse Drug Reactions of Glucocorticoid

Objective Through the analysis of the adverse drug reactions（ADR） of glucocorticoid to aim the improvement of cognition in medical staff and drugs rational use.Methods 39 cases of the ADR which took glucocorticoid were investigated in 10 years.Results In totally 39 cases,including 5 cases of Cushing＇s syndrome（12.8%）,2 cases of peptic ulcer（5.10%）,4 cases of gastrointestinal hemorrhage（10.3%）,5 cases of carbohydrate tolerance abnormity（12.8%）,3 cases of steroid diabetes（7.70%）,5 cases of hypertensive（12.8%）,4 cases of relapse or exacerbation in tuberculosis（10.3%）,5 cases of osteoporosis（12.8%）,3 cases of emotional disturbance（7.70%）,1 cases of epilepsy and epileptic seizures（2.60%）,1 cases of Femoral head necrosis（2.60%）,1 cases of skin allergy（2.60%）.Conclusion ADR of glucocorticoid therapy is not unusual and sever,even fatally.In order to improve the level of managing glucocorticoid it is important to think over various factor and to use cautiously.