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| 阿奇霉素注射剂致儿童心血管不良反应报告分析 |
| 胡静1,吴自勇1,王伟1,秦琴2,张敏3,向晖4 |
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| (1. 鄂州市中心医院,湖北鄂州 436000;2. 荆门市人民医院,湖北荆门 448000; 3. 湖北省黄石市第五医院,湖北黄石 435000;4. 鄂东医疗集团黄石市中心医院,湖北理工学院附属医院,湖北黄石 435000) |
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| 摘要: |
| 目的:分析阿奇霉素注射剂致儿童心血管不良反应临床特点,为临床合理用药提供参考。 方法:在 2013 年 1 月至 2021 年7 月鄂州市中心医院、黄石市中心医院和黄石市第五医院药物不良反应监测中心筛选出阿奇霉素注射剂致儿童心血管不良反应113 例,对患儿年龄、性别、不良反应发生时间、临床表现及转归进行回顾性分析。 结果:在 113 例阿奇霉素注射剂致儿童心血管不良反应中,83 例(73. 45%)为轻度不良反应,30 例(26. 55%)为中度不良反应;男女比例 1. 35 ∶ 1;69 例(61. 06%)年龄≤3 岁;71 例( 62. 83%) 溶媒为生理盐水,42 例( 37. 17%) 为 5% 葡萄糖注射液;75 例( 66. 37%) 患儿输液浓度为 2 mg / mL,38 例(33. 63%)输液浓度为 1 mg / mL;53 例(46. 90%)联用中药注射剂,33 例(29. 20%)联用茶碱类药物,30 例(26. 55%)联用非甾体抗炎药物;80 例(70. 80%)临床表现为 Q-T 间期延长,22 例为心律失常(19. 47%);42 例(37. 17%)发生时间在用药 1 h ~ 1 d,25 例(22. 12%)为用药 1~3 d。 经停药或对症治疗后均缓解。 结论:阿奇霉素注射剂致儿童心血管不良反应以 Q-T 间期延长常见,多发生于年龄≤3 岁、用药≤3 d、溶媒为生理盐水和输液浓度为 2 mg / mL 的患儿。 |
| 关键词: 阿奇霉素 注射剂 儿童 心血管 不良反应 |
| DOI：10. 13407/ j. cnki. jpp. 1672-108X. 2023.08.003 |
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| 基金项目: |
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| Cardiovascular Adverse Drug Reactions Induced by Azithromycin Injection in Children |
| Hu Jing1, Wu Ziyong1, Wang Wei1, Qin Qin2, Zhang Min3, Xiang Hui4 |
| (1.Ezhou Central Hospital, Hubei Ezhou 436000, China; 2. Jingmen People’s Hospital, Hubei Jingmen 448000, China; 3. The Fifth Hospital of Huangshi, Hubei Huangshi 435000, China; 4. Huangshi Central Hospital, Edong Group, Affiliated Hospital of Hubei Institute of Technology, Hubei Huangshi 435000, China) |
| Abstract: |
| Objective: To analyze the clinical characteristics of cardiovascular adverse drug reactions induced by azithromycin injection in children, so as to provide reference for clinical rational drug use. Methods: From Jan. 2013 to Jul. 2021, 113 children with cardiovascular adverse drug reactions induced by azithromycin injection were screened out from the adverse drug reaction monitoring platform of Ezhou Central Hospital, Huangshi Central Hospital and the Fifth Hospital of Huangshi. The age, gender, occurrence time of adverse drug reactions, clinical manifestations and outcomes of the children were retrospectively analyzed. Results: Among 113 cases of cardiovascular adverse drug reactions induced by azithromycin injection, 83 cases (73. 45%) were mild adverse drug reactions and 30 cases (26. 55%) were moderate adverse drug reactions. The male to female ratio was 1. 35 ∶ 1, and 69 patients (61. 06%) aged ≤3 years. The solvent was normal saline in 71 cases ( 62. 83%) and 5% glucose injection in 42 cases ( 37. 17%). The infusion concentration was 2 mg / mL in 75 cases (66. 37%) and 1 mg / mL in 38 cases (33. 63%). Totally 53 cases (46. 90%) were treated with traditional Chinese medicine injection, 33 cases (29. 20%) received theophylline drugs, and 30 cases ( 26. 55%) were given nonsteroidal anti-inflammatory drugs. The clinical manifestations were prolonged Q-T interval in 80 cases (70. 80%) and arrhythmia in 22 cases (19. 47%). The occurrence time of 42 cases (37. 17%) was mainly from 1 h to 1 d, and 25 cases (22. 12%) was from 1 to 3 d. All patients were relieved after drug withdrawal or symptomatic treatment. Conclusion: Prolonged Q-T interval is the most common cause of cardiovascular adverse drug reactions induced by azithromycin injection in children, mostly in children with age ≤3 years and administration time ≤3 d, with normal saline as the solvent and infusion concentration of 2 mg / mL. |
| Key words: azithromycin injection children cardiovascular adverse drug reactions |
