摘要
目的分析司美格鲁肽药物不良反应的临床表现及相关影响因素,以期为临床治疗提供参考。方法收集2022年1月—2023年12月在重庆市第九人民医院内分泌科就诊并接受司美格鲁肽治疗的597例患者临床资料。根据患者使用司美格鲁肽后是否发生不良反应,将患者分为有反应组(n=177)和无反应组(n=420)。收集患者姓名、年龄、性别、身体质量指数(BMI)、用药目的、司美格鲁肽维持剂量、电话,通过门诊随访或电话随访患者,详细记录患者用药后的任何不适症状。结果司美格鲁肽引起的不良反应最常见累及的器官/系统为消化系统,占比为82.48%。在177例发生不良反应患者中,有18例(10.16%)患者因该药所致胃肠道不良反应不能耐受而停止用药;有7例(3.95%)患者因该药所致不良反应相关症状持续不缓解而住院治疗;有2例(1.12%)患者因该药所致严重腹泻诱发基础疾病加重而死亡。比较2组患者临床资料,结果显示2组患者的BMI水平,超说明书用药人数比例以及用药目的方面差异存在统计学意义(P<0.05)。Logistic回归分析结果显示:低BMI、患2型糖尿病、超说明书用药是患者服用司美格鲁肽后发生不良反应的影响因素(P<0.05)。结论司美格鲁肽胃肠道不良反应发生率较高,同时,其还可能增加胆囊结石形成风险。建议临床使用司美格鲁肽应严格遵循适应证用药,用药前应对患者的消化系统及甲状腺状况进行评估,且用药过程中应密切关注其用药初期及长期不良反应的发生情况。
Objective To analyze the clinical manifestations and related influencing factors of adverse drug reactions(ADRs)to semaglutide,providing references for clinical treatment.Methods Clinical data from 597 patients treated with semaglutide at the Endocrinology Department of Chongqing Ninth People's Hospital from January 2022 to December 2023 were collected.Patients were assigned to two groups based on the occurrence of ADRs:the reaction group(n=177)and the non-reaction group(n=420).Data on patient's name,age,gender,body mass index(BMI),purpose of medication,semaglutide maintenance dose,and follow-up details or telephone calls were collected.Any discomfort post-medication was recorded thoroughly through outpatient or telephone follow-ups.Results The most common organ/system affected by semaglutide ADRs was the digestive system,accounting for 82.48%of cases.Among the 177 patients with ADRs,18 patients(10.16%)discontinued the drug due to intolerable ADRs,7 patients(3.95%)required hospitalization due to persistent ADR-related symptoms,and 2 patients(1.12%)died due to exacerbation of underlying diseases triggered by severe diarrhea.Significant differences between the two groups were observed in BMI levels,off-label drug use,and purpose of medication(P<0.05).Multivariate logistic regression analysis revealed that low BMI,type 2 diabetes,and off-label drug use were factors influencing the occurrence of ADRs to semaglutide(P<0.05).Conclusion Gastrointestinal ADRs are common with semaglutide,and it may also increase the risk of gallstone formation.It is recommended that semaglutide be used strictly according to indications,with an evaluation of the patient's digestive system and thyroid status before administration,and close monitoring of early and long-term ADRs during treatment.
作者
牟钰钦
罗易
王思琪
汤世国
Mou Yuqin;Luo Yi;Wang Siqi;Tang Shiguo(Department of Pharmacy,The Ninth People's Hospital of Chongqing,Chongqing 400700,China;Department of Endocrinology,The Ninth People's Hospital of Chongqing,Chongqing 400700,China)
出处
《保健医学研究与实践》
2024年第6期105-109,共5页
Health Medicine Research and Practice
基金
重庆市卫生健康委医学科研项目(2023WSJK031)。
关键词
司美格鲁肽
不良反应
临床表现
影响因素
Semaglutide
Adverse drug reactions
Clinical manifestations
Influencing factors
