替格瑞洛与氯吡格雷药品不良反应/不良事件对比分析

中国药物警戒 ›› 2019, Vol. 16 ›› Issue (1): 52-57.

• 安全性评价与合理用药 • 上一篇下一篇

替格瑞洛与氯吡格雷药品不良反应/不良事件对比分析

何桂林¹, 左丽², 王茜²

¹北京大学深圳医院药学部,广东深圳 518036;
²深圳市药品不良反应监测中心药品监测部,广东深圳 518036

收稿日期:2018-08-28 修回日期:2019-02-18 出版日期:2019-01-20 发布日期:2019-02-18
作者简介:何桂林,女,博士,主管药师,临床药学。E-mail：jxheguilin@126.com。
基金资助:
深圳市卫生计生系统科研项目（SZFZ2017050）：深圳市2014至2016年用药错误分析及防范措施的研究

Comparative Analysis of Adverse Drug Reactions/Adverse Events between Ticagrelor and Clopidogrel

HE Guilin¹, ZUO Li², WANG Qian²

¹Department of Pharmacy, Peking University Shenzhen Hospital, Guangdong Shenzhen 518036, China;
²Department of Drugs Monitoring, Center for ADR Monitoring of ShenZhen, Guangdong Shenzhen 518024, China

Received:2018-08-28 Revised:2019-02-18 Online:2019-01-20 Published:2019-02-18

摘要/Abstract

摘要： 目的对比分析替格瑞洛和氯吡格雷致药品不良反应/不良事件（ADR/AE）,为临床安全、合理选择抗血小板药物提供参考。方法对深圳市2014~2017年间共上报的怀疑替格瑞洛和氯吡格雷的病例报告进行统计分析。结果共筛选出31例怀疑替格瑞洛所致ADR/AE报告、43例怀疑氯吡格雷所致的ADR/AE报告;均以男性为主,但替格瑞洛男女比例更明显;替格瑞洛ADR多发生在用药2~7 d 内（35.48%）,而氯吡格雷ADR多发生在1 d及2~7d内（分别为32.56%、30.23%）;替格瑞洛ADR/AE以出血（56.46%）及呼吸困难（33.33%）多见,氯吡格雷不良反应涉及系统器官及不良反应表现较多;在ADR/AE结果中,替格瑞洛与氯吡格雷ADR多数较轻微,易于好转和治愈,但患者对替格瑞洛不良反应耐受性更好,同时氯吡格雷出现了1例ADR/AE导致死亡报告。结论临床医师和药师在患者开始使用替格瑞洛或氯吡格雷一周内应加强关注其不良反应,密切监测服用替格瑞洛患者的出血及呼吸系统的不良反应,注意氯吡格雷的安全用药,积极防范ADR/AE的发生。

关键词: 替格瑞洛, 氯吡格雷, 药品不良反应/事件

Abstract: Objective To compare the adverse drug reactions/adverse events (ADRs/AEs) caused by ticagrelor and clopidogrel, in order to provide reference for clinical safe and rational use of the antiplatelet agents. Methods ADR/AE cases caused by ticagrelor and clopidogrel were screened and analyzed statistically from ADR/AE cases reported in Shenzhen city from 2014 to 2017. Results 31 ADR/AE cases caused by ticagrelor and 43 caused by clopidogrel were screened out. All of the ADR/AE cases were mainly male, however, the ratio of ticagrelor males and females was more obvious. The onset time of most ADRs/AEs by ticagrelor was within 2 to 7 days after oral medication (35.48%), and that of clopidogrel was mostly within 1 day and 2 to 7 days (32.56%, 30.23%). The main clinical manifestations by ticagrelor were bleeding(56.46%) and dyspnea(33.33%). The involved system-organs and clinical manifestations by clopidogrel were more than that by ticagrelor. Most clinical manifestations by ticagrelor and clopidogrel were mild and had good prognosis, but the patients were more tolerant to ticagrelor compared with clopidogrel. One fatal case was reported by clopidogrel. Conclusion Clinicians and clinical pharmacists should pay more attention to monitor ADRs/AEs by tigrelor and copidogrel within one week. The bleeding and dyspnea by tigrelor should be more concerned. Clinic should strengthen medication monitoring to reduce ADRs and ensure drug safety.

Key words: ticagrelor, clopidogrel, adverse drug reactions/adverse events

中图分类号:

R994.11

何桂林, 左丽, 王茜. 替格瑞洛与氯吡格雷药品不良反应/不良事件对比分析[J]. 中国药物警戒, 2019, 16(1): 52-57.

HE Guilin, ZUO Li, WANG Qian. Comparative Analysis of Adverse Drug Reactions/Adverse Events between Ticagrelor and Clopidogrel[J]. Chinese Journal of Pharmacovigilance, 2019, 16(1): 52-57.

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替格瑞洛与氯吡格雷药品不良反应/不良事件对比分析

Comparative Analysis of Adverse Drug Reactions/Adverse Events between Ticagrelor and Clopidogrel

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