385例多重用药的老年细菌性肺炎住院患者药品不良反应特点及影响因素分析

doi:10.19803/j.1672-8629.20240645

摘要/Abstract

摘要： 目的分析多重用药的老年细菌性肺炎住院患者药品不良反应（Adverse Drug Reaction,ADR）特点及相关影响因素。方法回顾性分析2018年1月1日至2022年11月30日于首都医科大学宣武医院住院的老年细菌性肺炎患者情况,采用Naranjo评定法评价药物与ADR之间的关联性,采用《不良事件通用术语评价标准》（5.0版）对ADR的严重程度进行分级;运用向后选择法建立Logistic回归方程对危险因素进行分析。结果 4 967例老年细菌性肺炎住院患者中有385名患者发生464例次ADR,发生率为7.75%。ADR类型主要分布在胃肠系统（40.52%）、循环系统（14.44%）及肝功能损伤（12.28%）等。ADR共涉及相关药物671例次,主要为抗感染药物（63.79%）、抗凝药（6.56%）和抗血小板药物（6.41%）。ADR严重程度主要为1级（30.17%）和2级（59.91%）。多因素Logistic回归结果显示,住院天数、用药种数、药物过敏史、女性患者、脑血管疾病和结缔组织病会增加患者发生ADR的风险。结论通过分析老年细菌性肺炎患者发生ADR的危险因素,提示临床应加强对高风险患者ADR的监护与管理,为未来进一步开发老年细菌性肺炎住院患者ADR风险预测模型提供参考。

关键词: 细菌性肺炎, 老年患者, 多重用药, 胃肠系统, 抗感染药物, 药品不良反应, Logistic回归

Abstract: Objective To analyze the characteristics of and risk factors for adverse drug reactions (ADR) in elderly inpatients with bacterial pneumonia and treated with polypharmacy. Methods The clinical data of elderly inpatients with bacterial pneumonia treated between January 1, 2018 and November 30, 2022 was retrospectively analyzed. The correlations between drugs and ADR were evaluated using the Naranjo evaluation method while the severity of ADR was graded with Common Terminology Criteria for Adverse Events version 5.0. A logistic regression equation was established using the backward selection method to analyze the risk factors. Results Among the 4 967 elderly inpatients with bacterial pneumonia, there were 464 cases of ADR in 385 of these patients, so the overall incidence rate of ADR was 7.75% that were mostly related to the gastrointestinal system (40.52%), circulatory system (14.44%) and liver function injury(12.28%). A total of 671 related drugs were involved in ADR, such as anti-infective drugs (63.79%), anticoagulants (6.56%) and antiplatelet drugs (6.41%). The severity of ADR was primarily grade 1(30.17%) and grade 2(59.91%). Multivariate logistic regression results showed that days of hospitalization, numbers of medications, drug allergy history, being female, cerebrovascular diseases and connective tissue diseases increased the risk of ADR in patients. Conclusion Clinicians and pharmacists should be alert to ADR in high-risk patients. This study is expected to contribute to the development of risk prediction models of ADR for elderly inpatients with bacterial pneumonia in the future.

Key words: Bacterial Pneumonia, Elderly Patients, Polypharmacy, Gastrointestinal System, Anti-Infective Drugs, Adverse Drug Reaction, Logistic Regression

中图分类号:

R798.1
R743

刘碧晴, 张晓彤, 王可, 邢晓璇, 王之舟, 庄伟, 张青霞, 张兰, 李晓玲, 董宪喆. 385例多重用药的老年细菌性肺炎住院患者药品不良反应特点及影响因素分析[J]. 中国药物警戒, 2025, 22(2): 206-210.

LIU Biqing, ZHANG Xiaotong, WANG Ke, XING Xiaoxuan, WANG Zhizhou, ZHUANG Wei, ZHANG Qingxia, ZHANG Lan, LI Xiaoling, DONG Xianzhe. Adverse Drug Reaction in 385 Elderly Inpatients with Bacterial Pneumonia under Polypharmacy[J]. Chinese Journal of Pharmacovigilance, 2025, 22(2): 206-210.

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