摘要
目的从临床实例出发探讨药源性高尿酸血症的发生特点,为临床用药安全及风险管理提供依据。方法检索建库至2022年12月31日医药期刊公开发表的药源性高尿酸血症的病例报道,同时收集我院2010—2022年上报的药源性高尿酸血症不良反应(ADR)报告,提取患者性别、年龄、怀疑药品、药品的用法用量、血尿酸水平、ADR诱导时间、治疗与转归等信息进行统计分析。结果共纳入病例45例,其中文献病例18例,我院ADR病例27例。男性25例,女性20例,年龄14~82岁,平均年龄(53.18±19.45)岁;引起高尿酸血症的药物主要涉及抗结核药、利尿药、抗感染药、复方降压药、抗血小板药、质子泵抑制剂、调节免疫功能药和抗精神病药。用药后血尿酸>420~480μmol·L^(-1)的4例,>480~540μmol·L^(-1)的13例,>540μmol·L^(-1)的28例。高尿酸血症的诱导时间最短为2 d,最长数年。经停药、对症治疗或药物减量后血尿酸水平下降或恢复正常。结论多种药物可引起高尿酸血症,服用易引起高尿酸血症药物的患者,尤其是老年患者,应定期监测血尿酸水平。医务人员应了解易引起高尿酸血症的药物,做好用药风险管理,减少药源性高尿酸血症的发生。
Objective To discuss the occurrence characteristics of drug-induced hyperuricemia based on clinical examples,and to provide evidence for clinical drug safety and risk management.Methods Case reports of drug-induced hyperuricemia publicly published in medical journals from inception to December 31,2022 were retrieved,and adverse drug reaction(ADR)reports of drug-induced hyperuricemia reported in our hospital from 2010 to 2022 were collected.The information such as patient gender,age,suspected drugs,drug usage and dosage,blood uric acid level,ADR induction time,treatment and prognosis for statistical analysis was extracted.Results There were 18 cases searched for literature,and our hospital reported 27 cases of hyperuricemia related to ADR,totaling 45 cases,including 25 males and 20 females,aged 14-82 years,with an average age of(53.18±19.45)years.Drug-induced hyperuricemia mainly involved antituberculosis drugs,diuretics,antiinfective drugs,compound antihypertensive drugs,antiplatelet drugs,proton pump inhibitors,immunomodulatory drugs and antipsychotics.Among the 45 patients after treatment,serum uric acid was>420-480μmol·L^(-1)in 4 cases,>480-540μmol·L^(-1)in 13 cases,and>540μmol·L^(-1)in 28 cases.The time it takes to induce hyperuricemia varies from 2 days to several years.After drug withdrawal,symptomatic treatment or dose reduction,blood uric acid level decreased or returned to normal.Conclusions A variety of drugs can cause hyperuricemia.Patients taking these drugs,especially elderly patients,should monitor the blood uric acid levels regularly.Medical staff should know the drugs causing hyperuricemia,and do a good job in medication risk management to reduce the occurrence of drug-induced hyperuricemia.
作者
任晓蕾
詹轶秋
张春燕
黄琳
封宇飞
Xiao-Lei REN;Yi-Qiu ZHAN;Chun-Yan ZHANG;Lin HUANG;Yu-Fei FENG(Department of Pharmacy,Peking University People's Hospital,Beijing 100044,China;Clinical Trial Site,Peking University People's Hospital,Beijing 100044,China)
出处
《药物流行病学杂志》
CAS
2023年第9期969-974,共6页
Chinese Journal of Pharmacoepidemiology
