The adverse drug reactions (ADR) and its influencing factors of antituberculosis drug were analyzed retrospectively in 648 patients with newly tuberculosis matched with inclusion criteria in Rugao city in 2015.Clinical data frorm outpatients and inpatients of tuberculosis including medical order,medical history,medication and laboratory examination etc.were offered by tuberculosis physician.The study found that adverse drug reactions occurred in 317 cases (48.9％),of which 120 cases occurred two or more kinds adverse reactions,a total of 519times.The most common adverse events were elevated uric acid (42.4％,220/519),drug induced liver injury (15％,78/519),and gastrointestinal reactions (13.5％,70/519).In medicine,the highest adverse reactions were caused by pyrazinamide (49.9％,259/519),followed by rifampicin (16.6％,86/519).It occurred in intensive phase in 207 cases (65.3％) and in continuation phase in 110 cases (34.7％).It needed to adjust chemotherapeutic regimen due to adverse reaction in 78 cases (24.6％),in which 17 cases were interrupted due to sever adverse reaction.Multivariate regression analysis showed that age (β=1.18,Wald x2 =63.27,P＜0.001,OR=3.25,95％CI=2.43-4.35),history of liver disease (β=1.62,Wald x2 =22.51,P＜0.001,OR=5.03,95％CI=2.58-9.81),history of diabetes (β 1.85,Wald x2=29.48,P＜0.001,OR=6.37,95％CI=3.26-12.42),history of alcohol using (β =1.39.Wald x2=17.69,P＜0.001,OR =1.39,95％CI=2.10-7.66) were the relative risk factors of adverse drug reactions.In order to ensure the safety of clinical medication,doctors should be familiar with the common adverse reactions of antituberculosis drugs,strengthen publicity and education of knowledge of prevention and drug adverse reaction for patients with tuberculosis.According to the age and the patient's condition,drug use should be rational to avoid or reduce the occurrence of adverse drug reactions,and treat it timely.%回顾性分析2015年如皋市符合纳入标准的648例新发结核病患者结核性药物不良反应(adversedrug reactions,ADR)的发生情况及影响因素.所有患者资料[患者一年来所有的结核病门诊及住院患者的临床资料(包括临床医嘱单,病史资料,用药情况,实验室检查结果等)]均由结核科医师提供.研究发现,648例患者中发生药物不良反应者317例(48.9％),其中120例发生2种及2种以上不良反应,共计519例次.最多见的不良反应为尿酸增高(42.4％,220/519),肝损伤(15.0％,78/519)及胃肠道反应(13.5％,70/519).在抗结核药物中,吡嗪酰胺引起的不良反应最高(49.9％,259/519),其次是利福平(16.6％,86/519);其中207例(65.3％)发生在强化期,110例(34.7％)发生在巩固期.78例(24.6％)患者因不良反应需要调整治疗方案,其中17例(5.4％)因严重不良反应中断治疗.多因素回归分析表明,高龄(β=1.18,Wald x2=63.27,P＜0.001,OR=3.25,95％CI=2.43～4.35)、肝病史(β=1.62,Wald x2=22.51,P＜0.001,OR=5.03,95％CI=2.58～ 9.81)、糖尿病病史(β=1.85,Wald x2=29.48,P＜0.001,OR=6.37,95％CI=3.26～12.42)、饮酒史(β=1.39,Wald x2=17.69,P＜0.001,OR=1.39,95％CI=2.10～7.66)是影响药物不良反应的相关危险因素.故为保障临床用药安全,医生应熟知常见的抗结核药物的不良反应,加强患者对结核病防治知识及药物不良反应的宣传教育,根据患者年龄、病情等合理用药,尽量避免或减少药物不良反应的发生,并能够及时处理发生的药物不良反应.
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