中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2015年
4期
253-257
,共5页
老年人%药物不良反应%回顾性分析
老年人%藥物不良反應%迴顧性分析
노년인%약물불량반응%회고성분석
elderly%adverse drug reaction%retrospective analysis
目的：分析老年患者药物不良反应（ADR）发生的特点，以利于临床上提高监测和应对。方法回顾性地分析国家药品不良反应监测中心数据库收集的南京医科大学第一附属医院2012年1月至2014年11月＞65岁的老年患者的ADR报告。结果共收集212例次老年患者ADR报告（占总体ADR的21.3%），其中男性91例次，女性121例次，平均年龄（75.25±6.43）岁；91例次发生于门急诊（42.9%），114例次发生于住院非ICU（53.78%）；涉及药品98种，主要为抗感染药物（30.66%），其次为中枢神经系统药物（26.42%）；用药途径主要是静脉滴注（86.32%）；ADR所累及的器官或系统损害主要是全身性损害（23.10%），其次是皮肤及其附件损害（19.49%），主要表现为过敏样反应、皮疹。结论本研究反映了我院老年患者发生ADR的主要风险药物、给药途径、临床表现等，应重点关注应用高风险药物的人群，用药过程中密切监测。对门急诊、院外老年患者的用药安全及口服药物的安全性也应加以重视。由于存在漏报现象，本研究的报告率仅能从一定程度上反映老年患者ADR的发生情况，应进一步重视和加强老年患者ADR的监测上报工作。
目的：分析老年患者藥物不良反應（ADR）髮生的特點，以利于臨床上提高鑑測和應對。方法迴顧性地分析國傢藥品不良反應鑑測中心數據庫收集的南京醫科大學第一附屬醫院2012年1月至2014年11月＞65歲的老年患者的ADR報告。結果共收集212例次老年患者ADR報告（佔總體ADR的21.3%），其中男性91例次，女性121例次，平均年齡（75.25±6.43）歲；91例次髮生于門急診（42.9%），114例次髮生于住院非ICU（53.78%）；涉及藥品98種，主要為抗感染藥物（30.66%），其次為中樞神經繫統藥物（26.42%）；用藥途徑主要是靜脈滴註（86.32%）；ADR所纍及的器官或繫統損害主要是全身性損害（23.10%），其次是皮膚及其附件損害（19.49%），主要錶現為過敏樣反應、皮疹。結論本研究反映瞭我院老年患者髮生ADR的主要風險藥物、給藥途徑、臨床錶現等，應重點關註應用高風險藥物的人群，用藥過程中密切鑑測。對門急診、院外老年患者的用藥安全及口服藥物的安全性也應加以重視。由于存在漏報現象，本研究的報告率僅能從一定程度上反映老年患者ADR的髮生情況，應進一步重視和加彊老年患者ADR的鑑測上報工作。
목적：분석노년환자약물불량반응（ADR）발생적특점，이리우림상상제고감측화응대。방법회고성지분석국가약품불량반응감측중심수거고수집적남경의과대학제일부속의원2012년1월지2014년11월＞65세적노년환자적ADR보고。결과공수집212례차노년환자ADR보고（점총체ADR적21.3%），기중남성91례차，녀성121례차，평균년령（75.25±6.43）세；91례차발생우문급진（42.9%），114례차발생우주원비ICU（53.78%）；섭급약품98충，주요위항감염약물（30.66%），기차위중추신경계통약물（26.42%）；용약도경주요시정맥적주（86.32%）；ADR소루급적기관혹계통손해주요시전신성손해（23.10%），기차시피부급기부건손해（19.49%），주요표현위과민양반응、피진。결론본연구반영료아원노년환자발생ADR적주요풍험약물、급약도경、림상표현등，응중점관주응용고풍험약물적인군，용약과정중밀절감측。대문급진、원외노년환자적용약안전급구복약물적안전성야응가이중시。유우존재루보현상，본연구적보고솔부능종일정정도상반영노년환자ADR적발생정황，응진일보중시화가강노년환자ADR적감측상보공작。
Objective To analyze the features of adverse drug reaction (ADR) in the elderly (>65 years old) in order to improve its surveillance and coping strategies. Methods All ADR reports in the elderly patients from the First Affiliated Hospital, Nanjing Medical University during the years of 2012 to 2014 in the National Center for ADR Monitoring Database were collected and retrospectively analyzed. Results There were 212 ADR reports in the elderly patients (accounting for 21.3% of the total ADR reports). They were 91 males and 121 females, at an average age of (75.25±6.43)years. Ninety-one ADRs (42.9%) occurred in the outpatient or emergency department, and 114 reports occurred in the non-ICU inpatients. There were totally 98 drugs involved. The most ADRs were caused by anti-infective drugs (30.66%) and central nervous system drugs (26.42%). The common route of administration (86.32%) was venous injection. The system-organs involved by ADR in the cohort were mainly systematic damages (23.10%), and the damages in the skin and its appendages (19.49%). And the most common manifestations were hypersensitivity reactions and rash. Conclusion This study concludes the drugs and administration routes which are more likely to cause ADR and the main signs and symptoms of ADR in the elderly. We should focus on the patients receiving high-risk drugs administration and keep close monitoring during their whole course of medication. Attention should also be paid to the medication safety and the safety of oral drugs in the elderly in outpatient and emergency departments and in those outside a hospital. Due to the presence of uncounted ones, the rate in our report only partially reflects the incidence of ADR in the elderly. ADR surveillance and report for the elderly should be emphasized and strengthened.
