药源性心律失常影响因素的病例对照研究

目的：探讨药源性心律失常的影响因素,为临床提供参考。方法：采用1∶1配对病例对照研究方法,从江苏省药品不良反应监测中心的报表库中筛选出符合条件的病例组和对照组进行1∶1配对,然后进行单因素分析和多因素条件Logistic回归分析。结果：单因素分析筛选出8个具有统计学意义（P〈0.05）的因素;多因素条件Logistic回归分析结果表明其中6个因素易导致药源性心律失常,其OR（95%CI）分别为：治疗精神障碍药24.504（7.079～84.827）]、维生素类药及微量元素与营养药5.317（1.269～22.274）]、呼吸系统用药4.040（1.682～9.702）]、合并用药2.364（1.241～4.503）]、心血管系统药2.360（1.041～5.350）]、原患疾病为心血管疾病1.974（1.027～3.797）]。结论：用药前应注意药物的相互作用、原患疾病是否为心血管疾病,用治疗精神障碍药、维生素类药及微量元素与营养药、呼吸系统用药、心血管系统用药等药物时,应密切注意患者的反应,必要时进行电解质监测、心电图监测,减少或避免药源性心律失常的发生。

The Case control Study of the Influencing Factors of Drug Induced Arrhythmias

Objective:To investigate the influencing factors of drug-induced arrhythmias to provide reference for clinical practice.Methods:The cases and the controlled group were screened according to their condition with the method of 1∶ 1 matched case-control study.The single factor and multivariate logistic regression were analyzed by SPSS.Results:By univariate analysis,8 factors of statistical significance(P<0.05) were filtered out,and then a multivariate logistic regression analysis was made.The results showed that six factors led to drug-induced arrhythmias,and their OR(95% CI) respectively was:anti-mental disorder drugs 24.504(7.079-84.827)],vitamins and trace elements and nutritional drugs 5.317(1.269-22.274)],respiratory medicine 4.040(1.682-9.702)],concomitant medications 2.364(1.241-4.503)],cardiovascular medicine2.360(1.041-5.350)] and the original disease being cardiovascular disease 1.974(1.027-3.797)].Conclusion:Before treatment some attention should be paid to drug interactions and the original illness being cardiovascular disease.In the treatment with anti-mental disorder drugs,vitamins and trace elements and nutritional drugs,respiratory medicine and cardiovascular medicine,close attention should be paid to the patients’ responses and,if necessary,electrolyte and ECG monitoring should be conducted to reduce or avoid drug-induced arrhythmias.