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目的通过主动监测的方式获取我院内分泌病区因药物不良反应(ADR)入院的发生率及主要特征,为临床安全用药提供参考。方法临床药师通过床旁问诊方式采集内分泌病区2011年1月至2013年12月因药物不良反应入院患者的详细资料,并对药物不良反应类型、临床表现、怀疑药物、过敏史、住院时间、住院费用以及转归情况进行分析。结果 6 914例入院患者中共有40例因药物不良反应入院,占0.58%,男性13例,女性27例,平均年龄(54.82±15.85)岁,平均住院费用(10622.86±6 719.48)元,住院天数(12.85±7.57)d,其中A型药物不良反应有34例(85.0%),B型药物不良反应有6例(15.0%)。40例药物不良反应共11种药物不良反应表现类型,涉及怀疑药物27种,主要的药物不良反应表现有低血糖、肾小管损害继发低磷软骨,类固醇糖尿病,粒细胞缺乏(减少)、胰岛素过敏、低血钾,肝酶升高,胰岛素自身免疫综合症,电解质紊乱,甲亢以及甲减,涉及的怀疑药物主要有胰岛素、口服降糖药物,降糖中成药(保健品)、甲巯咪唑、阿德福韦酯、肾上腺皮质激素等。结论内分泌病区因药物不良反应住院的比例0.58%,但引起药物不良反应的多为内分泌的常用药物,药物不良反应表现如低血糖、低血钾、电解质紊乱等与内分泌系统疾病临床表现相似,常常会影响诊断,延误治疗,因此在诊疗过程中,应重视药物的药物不良反应因素。
Objective To obtain the incidence and main characteristics of hospital adulteration due to adverse drug reaction (ADR) by means of active monitoring and provide references for clinical safety medication. Methods Clinical pharmacists collected detailed information on patients admitted to hospital for endocrine disease from January 2011 to December 2013 through bedside consultation, and analyzed the types of adverse drug reactions, clinical manifestations, suspected drugs, history of allergy, length of hospital stay , Hospitalization costs and the outcome of the situation for analysis. Results A total of 6 914 hospitalized patients were hospitalized due to adverse drug reactions, accounting for 0.58%. There were 13 males and 27 females, with an average age of 54.82 ± 15.85 years and an average hospitalization cost of (10622.86 ± 6 719.48) yuan, hospitalization days (12.85 ± 7.57) d, of which 34 (85.0%) were adverse reactions of type A drugs and 6 (15.0%) of them were adverse reactions of type B drugs. Forty adverse drug reactions were observed in 11 adverse drug reactions, including 27 suspected ones. The main adverse drug reactions were hypoglycemia, secondary hypophrenic tubular damage, steroid diabetes, agranulocytosis (decreased), insulin Allergy, hypokalemia, elevated liver enzymes, insulin autoimmune syndrome, electrolyte disorders, hyperthyroidism and hypothyroidism, the main suspected drugs are insulin, oral hypoglycemic drugs, hypoglycemic agents (health products), methimazole , Adefovir dipivoxil, adrenal cortex hormones and so on. Conclusion The ratio of endocrine hospitalization due to adverse drug reactions in endocrine ward was 0.58%. However, most of the adverse drug reactions caused by endocrine drugs were commonly used drugs for endocrine. The adverse drug reactions such as hypoglycemia, hypokalemia, electrolyte imbalance were similar to the clinical manifestations of endocrine system diseases. Often affect the diagnosis, delay treatment, so in the course of diagnosis and treatment, should pay attention to drug adverse drug reactions.