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目的:总结引起不良反应的药物及临床表现,为临床合理用药提供依据。方法:应用Access 2003及Excel 2003对15 873份药品不良反应(ADR)报告从年龄、性别、给药途径、上报人员等方面进行回顾性分析。结果:2008-2010年南京市药品ADR报告数量呈逐年上升趋势,由2008年的4 825例上升至2010年的5 775例。发生ADR男女比例为0.9︰1;成人ADR发生例数占总ADR例数的82.42%;上报人员职业主要以医师和药师为主;发生ADR的给药途径以静脉滴注为主,其次为口服给药,两者占总给药途径的94.59%;ADR累及的系统及器官中,皮肤及其附件损害占第一位(46.68%);临床上引起ADR的药物主要集中在抗感染药物、循环系统药物、中枢及外周神经系统药物等,其中抗感染药物引起的ADR例数最多(45.16%)。结论:临床医师应根据抗感染药物临床应用指导原则,严格把握适应证,并参考药敏试验结果选用抗感染药物,对有过敏史的患者应加强用药监护,尽量减少ADR的发生。
OBJECTIVE: To summarize the drugs and clinical manifestations that cause adverse reactions and provide the basis for clinical rational drug use. Methods: A total of 15 873 reports of adverse drug reactions (ADR) were retrospectively analyzed in terms of age, sex, route of administration and reporting personnel using Access 2003 and Excel 2003. Results: The number of drug ADR reports in Nanjing increased from 4825 in 2008 to 5775 in 2010. The incidence of ADR between men and women was 0.9: 1; the number of cases of adult ADR accounted for 82.42% of the total number of cases of ADR; escalation of occupational mainly doctors and pharmacists; ADR route of administration to intravenous drip, followed by oral Which accounted for 94.59% of the total administration route. In the systems and organs involved in ADR, the skin and its accessories accounted for the first place (46.68%). The clinically ADR-causing drugs mainly focused on anti-infective drugs, Systemic drugs, central and peripheral nervous system drugs, among which anti-infective drugs caused the highest number of ADR cases (45.16%). Conclusion: Clinicians should strictly follow the guidelines for the clinical application of anti-infectives, strictly follow the indications, and select the anti-infectives with reference to the drug susceptibility test results. Patients with allergies should be monitored intensively to minimize the occurrence of ADR.