45例右旋糖酐40葡萄糖注射液不良反应分析Analysis of 45 Cases of Adverse Reactions of Dextran 40 Glucose Injection
史荣华,杨玉志,管裕
SHI Ronghua,YANG Yuzhi,GUAN Yu
摘要(Abstract)：
目的监测右旋糖酐40葡萄糖注射液发生不良反应发生情况,为其临床合理使用提供参考。方法收集本院2013-01~2015-03发生的45例右旋糖酐40葡萄糖注射液不良反应并进行统计分析。结果本院右旋糖酐40葡萄糖注射液不良反应发生率为1.67%,主要发生在首次给药时。主要临床表现为荨麻疹、红色丘疹等过敏反应,严重不良反应为过敏性休克。其中42例不良反应均存在合并使用易致敏药物情况。结论右旋糖酐40葡萄糖注射液的不良反应发生与多种因素相关。合理使用时,应严格掌握适应证,减少合并用药,并仔细观察,做好严重不良反应发生的防范措施。
OBJECTIVE To promote the rational application of dextran 40 glucose injection by monitoring adverse drug reactions( ADR). METHODS All of the ADR case reports of dextran 40 glucose in Chashan hospital were collected and analyzed from January2013 to March 2015. RESULTS The incidence rate of dextran 40 glucose injection ADR was 1.67% and most of them happened when given at the first time. The main type of ADR was allergic reactions such as red papules and urticaria,serious adverse reaction was anaphylactic shock. 42 ADR cases existed in combination with other sensitization drugs. CONCLUSION Adverse drug reactions of dextran 40 glucose injection are related to multiple factors. To ensure drug rational,we should comply strictly with its indication,reduce the drug combination,observe carefully and prevent serious adverse reaction.
关键词(KeyWords)：
右旋糖酐40葡萄糖注射液;不良反应;合理用药
Dextran 40 Glucose injection;adverse drug reactions;rational drug use
基金项目(Foundation):
作者(Author):
史荣华,杨玉志,管裕
SHI Ronghua,YANG Yuzhi,GUAN Yu
参考文献(References)：
- [1]李大魁,金友豫,汤光,等.马丁代尔药物大典[M].原著第三十七版.北京:化学工业出版社,2014:1025-1026.
- [2]陈雪梅,金国栋,杜薇薇.低分子右旋糖酐注射液的不良反应报告[J].北方药学,2013,10(9):40.
- [3]卢忠友.成功抢救低分子右旋糖酐过敏性休克1例的临床体会[J].中国伤残医学,2013,21(11):488-489.
- [4]顾正平,刘彦儒.低分子右旋糖酐氨基酸致过敏性休克1例[J].药物不良反应,2013,32(3):404.
- [5]陈锡创,洪远,叶建林.右旋糖酐40致过敏性休克死亡危险因素的Logistic回归分析[J].医药导报,2014,33(9):1243-1246.
- [6]谢勇,雷陈,雷招宝.右旋糖酐致26例患者死亡原因分析[J].中国执业药师,2014,11(5):7-10.
- [7]刘燕.联合静滴低分子右旋糖酐与复方丹参致过敏性休克并死亡1例[J].医学信息,2013,26(16):523.
- [8]李钟勇,何清华.右旋糖酐40致过敏性休克的影响因素分析[J].中国实用医药,2010,5(28):152.
- [9]Aronson JK.MEYLER.药物副作用—国际药物不良反应和相互作用百科全书[M].第15版.北京:科学出版社,2007:1082-1088.
- [10]郭菁菁,沈志华,李明祥,等.灯盏花素注射液致过敏性休克1例[J].中国药师,2012,15(12):1775-1776.
- [11]严春燕.复方氨基酸静脉滴注致过敏性休克死亡[J].药物不良反应杂志,2010,12(1):60.
- [12]黄丽贞,雷光远,雷招宝.右旋糖酐氨基酸注射液不良反应分析[J].药物流行病学杂志,2012,21(10):520-522.
- [13]Kawano H,Nomura K,Kawahito S,et al.Dextran-induced anaphylactic shock during general anesthesia:a case report.Masui[J].The Japanese Journal of Anesthesiology,2012,11(61):1265-1268.
- [14]金伯泉,熊思东.医学免疫学[M].第5版.北京:人民卫生出版社,2010:176.
- [15]Hernández D,de Rojas F,Martínez Escribano C,et al.Fatal dextran-induced allergic anaphylaxis[J].Allergy,2002,57(9):862.
- [16]四川美康医药软件研究开发有限公司,国家食品药品监督管理局药品评审中心.药物临床信息参考[M].四川科学技术出版社,2008:874-875.
- [17]赵柱莲,肖芳莲.低分子右旋糖酐致不良反应事件的防治[J].泸州医学院学报,2010,3(66):664-666.