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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。
Objective: To investigate the influencing factors of drug-induced arrhythmia, to provide a reference for clinical practice. Methods: The 1: 1 matched case-control study method was used to select the eligible cases and control groups from the report database of ADR surveillance center in Jiangsu Province for 1: 1 pairing, and then univariate analysis and multivariate Logistic regression analysis. Results: Eight factors with statistical significance (P <0.05) were screened by univariate analysis. Logistic regression analysis showed that six of these factors could easily lead to drug-induced arrhythmia. The OR (95% CI) : Treatment of mental disorders [24.504 (7.079-84.827)], vitamins and trace elements and nutritional medicine [5.317 (1.269-22.274)], respiratory medicine [4.040 (1.682-9.702)], combination therapy [2.364 (1.241 ~ 4.503)], cardiovascular system medicine [2.360 (1.041-5.350)], and the original disease was cardiovascular disease [1.974 (1.027-3.779)]. Conclusions: The drug interaction should be noticed before treatment, whether the original disease is cardiovascular disease, the treatment of mental disorders, vitamins and trace elements and nutrition drugs, respiratory system drugs, cardiovascular system drugs and other drugs should be close Pay attention to the patient’s response, if necessary, electrolyte monitoring, ECG monitoring, to reduce or avoid the occurrence of drug-induced arrhythmia.