目的:基于某三级甲等医院电子病历系统,回顾性分析2016年肝生化指标异常住院患者的基本情况,并对患者输液用药与发生肝生化指标异常变化的相关性进行分析,挖掘输液药物不良反应信号.方法:利用Excel 2007对患者性别、年龄、输液用药使用情况进行统计分析,并分析不同年龄层患者中输液药物与肝生化指标异常相关性,计数资料利用x2检验(x2)比较统计学意义,并运用单因素Logsitic回归计算优势比(OR),从而进行关联度大小判断.结果:共统计1 395例肝生化指标异常患者,男性791例,女性604例,共纳入可疑药物151种,其中＜18岁组23种,18～59岁组76种,≥60岁组52种,种类最多为抗感染药物.说明书标注肝生化指标异常且关联度较高的药物中,伏立康唑、替加环素、胺碘酮分别为＜18岁组、18～59岁组、≥60岁组相关度最高的药物.在说明未标注的药物中,依托泊苷、去甲肾上腺素、氨甲环酸3种药物具有文献报道提示引起肝功能异常的不良反应.结论:3个年龄组共151种输液药物的使用与肝生化指标异常具有一定的相关性,对输液药物的安全使用起到警示作用,为药物不良反应信号挖掘提供研究思路.

OBJECTIVE To explore the profile and rationality of intravenous infusion in critically ill patients in a tertiary A hospital.METHODS The situations of patients in intensive care unit (ICU) were reviewed for intravenous infusion from July2015 to June 2016, and basic information, costs, diagnosis of disease and infusion drugs were summarized.According to drug labels and articles, irrationality of solvents and compatibility were analyzed.RESULTS A total of 6 427 patients were enrolled, transfused with23.95 sets (average 60.85 bottles) in an average transfusion cycle of about 4.89 days.Most patients were diagnosed with cerebral hemorrhage, heart disease or lung cancer, and about 90.30％ patients were cured or improved, mainly admitted in ICU (37.45％).Of infusion drugs used in large amounts, edaravone injection, Ringer solution and potassium chloride injection showed relatively more problems such as unreasonable solvent and drug incompatibility.Injections not suitable to mix with other drugs in the same infusion, including compound musk injections (79.07％irrational rate), deoxyribonucleotide injections (66.67％), and deproteinised calf blood serum injection (58.25％), were still inappropriately mixed with other drugs.CONCLUSION This study demonstrates that infusion therapy is widely used in critically ill patients in this hospital.However, there are many inappropriate use problems of intravenous infusion including inappropriate solvent and drug incompatibility.More attentions should be paid to these infusion drugs with more common inappropriate issues.This hospital is intended to build the monitoring and pre-warning system and comprehensive assessment system for infusions to carry out hospital infusion management and implement requirements for rational use of drugs.