OBJECTIVE:To probe into the practice and effects of informationalized automatic monitoring on liver injury inpatients induced by key drugs based on the data in hospital information system.METHODS:With the utilization of drug-induced liver injury module based on the trigger principle of the self-made automatic monitoring system,automatic monitoring on key drugs was conducted on a larger samples,and the suspected cases submitted by the system were manually reviewed,the acurate incidence of drug-induced liver injury were obtained.RESULTS:In recently years,the total cases of inpatients with drug-induced liver injury monitored by informationalized automatic monitoring system were 1 215-11 665 cases.The target drugs were respectively atorvastatin calcium,cefoperazone sulbactam sodium,levofloxacin,moxifloxacin,taxol(albumin) and cinepazide;the incidence of drug-induced liver injury were respectively 7.30％ (17/233),6.26％ (38/607),1.93％ (34/1 763),4.7％ (84/1 788),14.53％ (192/1 321),7.11％ (15/211) and 0.87％ (92/10 605).CONCLUSIONS:Automatic monitoring software can effectively and rapidly obtain the accurate incidence of adverse drug reactions of key drugs in reality,the included rate negatively correlated with the positive predictive rate;in addition,it can be appropriately adjusted according to research needs and can be used for real-time monitoring and help to predict the risk of clinical medication.%目的:探讨围绕医院信息系统中的住院患者数据信息,开展重点品种的药源性肝损伤自动监测的实践及效果.方法:利用解放军总医院(以下简称“我院”)自行研发的自动监测系统中基于触发器原理的药源性肝损伤模块,针对多个重点监测品种分别进行大样本量用药人群的自动监测,并对其报警病例进行人工甄别,获得药源性肝损伤准确发生率.结果:近年来,我院先后利用系统开展药源性肝损伤主动监测的用药总例次数为1215～11 665例次,纳入监测的样本量为233 ～10 605例次;目标药物分别有阿托伐他汀钙、头孢哌酮舒巴坦钠、左氧氟沙星、莫西沙星、紫杉醇(白蛋白)、桂哌齐特,其致药源性肝损伤的发生率分别为7.30％(17/233)、6.26％(38/607)、1.93％(34/1 763)、4.7％ (84/1 788)、14.53％(192/1 321)、7.11％(15/211)、0.87％(92/10 605).结论:自动监测专用软件可高效快捷地获取重点监测品种在真实世界的药品不良反应准确发生率,其病例纳入率与阳性预测率呈负相关,可根据研究需要适当权衡;也可用于实时监测,追踪并预警临床用药风险.
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