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学科主题药剂学
风湿免疫疾病患者应用环孢素治疗的不良反应分析
其他题名Analysis on adverse drug reactions caused by cyclosporine in patients with rheumatic diseases
吴丽瑶1; 盛晓燕1; 马凌悦1; 赵侠1; 周颖1; 崔一民1
关键词风湿性疾病 安全 环孢素 Rheumatic Diseases Safety Cyclosporin
刊名药物不良反应杂志
2015
DOI10.3760/cma.j.issn.1008-5734.2015.03.006
3页:181-184
收录类别中国科技核心期刊 ; CSCD
文章类型Journal Article
摘要目的:了解风湿免疫疾病患者应用环孢素治疗过程中不良反应的发生情况及其特点。方法收集2013年1月至2014年12月因风湿免疫疾病在北京大学第一医院住院并使用环孢素(用药时间≥3 d)患者的病历资料进行回顾性分析。结果共收集到符合入选标准的患者46例,原发疾病主要为系统性红斑狼疮(20例)、皮肌炎(8例)、干燥综合征(6例)和未分化结缔组织病(4例)。46例患者联用药物种类为2~13种,均合并使用激素,39例联用非甾体抗炎药物;12例联用其他免疫抑制剂;20例联用抗生素;15例联用降糖药物;14例联用抗高血压药物;8例联用质子泵抑制剂。46例患者中21例出现环孢素相关不良反应(33例次),发生率为45.7%。21例患者中出现1种不良反应者14例,出现2种不良反应者3例,出现3种不良反应者3例,出现4种不良反应者1例。不同表现不良反应发生率:感染21.7%(10/46),尿素氮升高10.9%(5/46),胃肠道反应10.9%(5/46),血糖升高8.7%(4/46),血压升高8.7%(4/46),肝功能损伤6.5%(3/46),头痛、头晕2.2%(1/46),白细胞减少2.2%(1/46)。重度不良反应5例,其中结核复发2例,原有肺间质病变加重1例,消化性溃疡1例,经停药或对症处理后均好转;反复多部位感染1例,停药后因原发病治疗无效死亡。中度不良反应8例,对症治疗后转归良好。轻度不良反应8例中7例自行缓解,1例因出院转归不详。结论风湿免疫病患者应用环孢素后不良反应发生率较高,尤以感染发生率较高且较为严重。用药过程中应警惕感染,加强血压、血糖和肝肾功能监测。 Objective To explore adverse reactions induced by cyclosporine in patients with rheumatic diseases. Methods Clinical data of patients diagnosed with rheumatic diseases and treated with cyclosporine( 3 d)in Peking University First Hospital from January 2013 to December 2014 were collected and analyzed retrospectively. Results Data of a total of 46 patients in accordance with inclusion criteria were collected. Of them, 20 patients were diagnosed with systemic lupus erythematosus, 8 with dermatomyositis,6 with sicca syndrome,and 4 with undifferentiated connective tissue diseases and etc. There were 2-13 kinds of combination drugs in this 46 patients. In addition to cyclosporine treatment,all of them were treated with glucocorticoid,39 with non-steroidal antiinflammatory drugs,12 with other immune suppressants,20 with antibiotics,15 with hypoglycemic drugs,14 with antihypertensive drugs,and 8 with proton pump inhibitors at the same time. Of the 46 patients,21 developed 33 patient-time adverse drug reactions and the incidence was 45. 7%. Of the 21 patients,14 patients developed 1 kind of adverse reaction,3 patients developed 2 kinds of adverse reactions,3 patients developed 3 kinds of adverse reactions,and 1 patients developed 4 kinds of adverse reactions. The incidence of different adverse reactions were as follow:infection 21. 7%(10/46),urea nitrogen increase 10. 9%(5/46),gastrointestinal reactions 10. 9%(5/46),blood glucose increase 8. 7%(4/46),blood pressure increase 8. 7%(4/46),and liver injury 6. 5%(3/46),dizziness and headache 2. 2%(1/46),and hypoleucocytosis 2. 2%(1/46). Severe adverse reactions occurred in 5 patients and in 4 of them improved after treatments with drug withdrawal or symptomatic therapy,including recurrence of pulmonary tuberculosis in 2 patients,aggravation of original interstitial lung disease in 1 patient,and peptic ulcer in 1 patient;the fifth patient with repetitive infection died of primary disease after drug withdrawal. Moderate adverse reactions in 8 patients improved after symptomatic treatments. Mild adverse reactions in 7 patients were self-relieved and not clear in 1 patient because of discharge. Conclusions The incidence of adverse reactions induced by cyclosporine is high. The incidence of infection is higher and more severe. During the treatments,infection,blood glucose,blood pressure,and liver and renal function should be monitored to ensure medication safety.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/43916
专题北京大学第一临床医学院_药剂科
作者单位1.100034北京大学第一医院药剂科
2.北京大学药学院药事管理与临床药学系
3.100034北京大学第一医院药剂科
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GB/T 7714
吴丽瑶,盛晓燕,马凌悦,等. 风湿免疫疾病患者应用环孢素治疗的不良反应分析[J]. 药物不良反应杂志,2015(3):181-184.
APA 吴丽瑶,盛晓燕,马凌悦,赵侠,周颖,&崔一民.(2015).风湿免疫疾病患者应用环孢素治疗的不良反应分析.药物不良反应杂志(3),181-184.
MLA 吴丽瑶,et al."风湿免疫疾病患者应用环孢素治疗的不良反应分析".药物不良反应杂志 .3(2015):181-184.
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