乌鲁木齐市抗结核药物不良反应的发生情况及相关因素的调查

发布时间：2018-06-21 22:27

本文选题：抗结核药物不良反应 + 发生率　；参考：《新疆医科大学》2016年硕士论文

【摘要】：目的:了解乌鲁木齐市抗结核药物不良反应(Adverse Drug Reactions,ADRs)的发生情况,并探讨其影响因素。为早期识别和预防ADRs的发生提供科学依据。方法:本研究采用横断面研究设计方法,选取2013年1月至2014年12月在新疆乌鲁木齐市结核病防治定点医院接受治疗的肺结核患者作为研究对象。在患者开始治疗后的第0,2,5,6月末,对其进行肝、肾功能及血常规检测,并记录服药期间出现的不良反应情况。收集并整理研究对象的相关资料(病历资料、服药单记录、化验单及ADRs等相关信息)。按照ADRs判断标准分为ADRs组及正常组,采用单因素及多因素logisistic回归探讨ADRs可能的相关因素。结果:ADRs的总发生率为60.62%。多因素Logistic回归显示:与汉族相比,维吾尔族、哈萨克族、其他少数民族发生ADRs危险较低;与转诊相比,追踪、因症就诊、因症推荐发生ADRs危险较低;与强化期督导相比,全程管理发生ADRs危险较低。与未服用固定剂量复合制剂(Fixed-Dose Combination,FDC)患者相比,服用FDC患者容易发生ADRs。复治患者、HIV抗体检测阳性患者及既往有卡介苗接种史、肝病史、过敏史患者在抗结核治疗期间较易发生ADRs。结论:在抗结核治疗过程中,对复治患者、既往有肝病史、药物过敏史、HIV抗体检测阳性等高危患者,在接受抗结核治疗的强化期(前两个月内)密切检测其肝、肾功能,将血常规检查也加入常规检测项目中,详细记录并观察肺结核患者在治疗期间不良反应发生情况,以便及时了解ADRs的发生和采取相应措施。
[Abstract]:Objective: to investigate the occurrence of Adverse drug reactions (ADRs) in Urumqi and its influencing factors. To provide scientific basis for early identification and prevention of ADRs. Methods: a cross-sectional study design method was used to select pulmonary tuberculosis patients who received treatment from January 2013 to December 2014 in a designated hospital for tuberculosis control in Urumqi, Xinjiang. The liver, kidney function and blood routine examination were performed at the end of the 5th month after the patients began treatment, and the adverse reactions during the treatment were recorded. Collect and organize the data of the subjects (medical records, medication records, laboratory sheets and ADRs, etc.). According to ADRs criteria, ADRs were divided into ADRs group and normal group. Univariate and multivariate logisistic regression was used to explore the possible related factors of ADRs. Results the total incidence of 7% ADRs was 66. 62%. Multivariate logistic regression analysis showed that the risk of ADRs in Uygur, Kazak and other minority nationalities was lower than that in Han nationality, the risk of ADRs was lower than that of referral, and the risk of ADRs was lower than that of referral, and the risk of ADRs was lower than that of intensive supervision. The risk of ADRs in the whole course of management was lower. Patients taking FDC were more likely to develop ADRsthan those who did not take Fixed-Dose Combination- FDC (Fixed-Dose Combination- FDC). Patients with positive HIV antibody test and previous history of BCG vaccination, liver disease and allergic history were more likely to develop ADRsduring anti-tuberculosis treatment. Conclusion: in the course of anti-tuberculosis treatment, the liver and kidney functions of patients with recurrent treatment, with history of liver disease, history of drug allergy and HIV antibody detection were closely examined during the intensive period (within the first two months) of anti-tuberculosis treatment. Blood routine examination was added to routine examination item to record and observe the occurrence of adverse reactions of pulmonary tuberculosis patients during treatment in order to understand the occurrence of ADRs in time and take corresponding measures.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R52

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