目的：分析硫酸依替米星不良反应的临床特征、相关因素，为硫酸依替米星所致不良反应的防治提供可靠的参考依据。方法：对2003年11月～2004年5月我院使用硫酸依替米星注射剂的住院患者出现的不良反应及联合用药情况进行调查分析。结果：使用单一抗生素1096例，联合用药2029例；不良反应发生率为4.54%(142/3125),听觉和前庭功能损害16例,发生率为0.5% (16/3125)；泌尿系统损害14例，发生率为0.45% (14/3125)；肝胆系统损害4例，发生率为0.13% (4/3125)。 结论：硫酸依替米星是氨基糖苷类抗生素中安全性较高的药物。为了预防和减少不良反应的发生，需注意用药剂量、浓度、滴速配伍禁忌
背景与目的 对卫生保健干预措施进行决策权衡需要有不良和有益的可靠证据,然而绝大多数系统评价针对的是研究方法非常成熟的随机对照试验及其有效性评价,系统地评价不良反应的方法尚未完善,对研究者而言,能作为相关指南的资源很少.为此,作者在文中报告了对不良反应进行系统评价的新近体会,同时提出进一步实践和研究的建议.方法 描述并比较3个包含不良反应评价的药物干预的系统评价的方法学,重点评价其研究问题、研究设计和质量评价.结果 1个研究关注于如何根据提供的特殊不良反应数据建立卫生经济学模式,而其它两个研究涉及更广泛的问题.尽管每个评价对纳入标准的定义不同,但它们均纳入了随机和观察性数据.对研究质量的评价采用了标准方法.由于研究设计不良、报告不充分和现有研究工具有限,在运用纳入标准和评估研究质量时,研究者遇到了各种问题.最终发现,3个评价都做了大量的工作,但对卫生保健决策者有用的资料不多.研究者确认,改善的关键在于如何提出系统评价的问题和发展不良反应研究的质量评价方法学.结论 若不良反应的系统评价只专注于一个中心问题,那么它会提供与临床决策更相关的资料,也有利于明确纳入系统评价研究的类型.系统评价中不良反应的质量评估的方法学需要进一步完善.
ObjectiveTo evaluate the clinical efficacy of shenfu injection in reducing the side effects of chemotherapy in patients with cancer. MethodsWe searched Medline, PubMed, EMbase, VIP, Chinese science and technology periodical database full text database, China journal full database, Chinese biomedical literature database, and WANFANG database the durationi was from January 1994 to May 2013 for controlled trials about the use of shenfu injection to reduce the side effects of chemotherapy, without any language limitations. The quality of literature was evaluated by Jadad rating scale, and the included trials were analyze for systematic review. ResultsA total of 30 articles were included, and all of them were from Chinese literature. There were altogether 2039 cases. Compared with single chemotherapy group, the normal rate of white blood cells [RR=1.54, 95%CI (1.28, 1.84), P<0.0000 1], hemoglobin [RR=1.30, 95%CI (1.14, 1.48), P<0.000 1], platelet [RR=1.39, 95%CI (1.19, 1.62), P<0.000 1], and the number of patients without vomiting or sickness [RR=1.54, 95%CI (1.30, 1.81), P<0.0000 1] in the shenfu treatment group were all significantly higher. The life quality of the shenfu treatment group was also obviously better than the single chemotherapy group. ConclusionCompared with single chemotherapy, shenfu injection can reduce the peripheral blood cell reduction, gastrointestinal reaction and improve the patients' quality of life. Because the quality of included studies in this research is generally low, it is necessary to design a more reasonable and strict experiment with a large sample to get an exact conclusion.
Objective To investigate the effects of antiepileptic drugs (AEDs) with warfarin functions and blood coagulation system, to provide the reference for clinicians of the selection of AEDs under the combination therapy with warfarin. Methods Analyse the clinical data of the patient with symptomatic epilepsy from the Second Clinical Medical College of Guiyang University of Chinese Medicine on April 1, 2017, whom taking AEDs and warfarin at the same time, clear the drug adverse reactions, and analysed related literature. Results After the treatment with valproate, abnormal blood coagulation, a danger and emergency data appeared, so we stopped using warfarin immediately, and reduce the dosage of valproate gradually, insteadly, we used levetiracetam as antiepileptic therapy. Monitoring blood coagulation function, when it returned to normal, restart warfarin anticoagulant therapy. Conclusions When start antiepileptic treatment in relevant basic diseases of symptomatic epilepsy, for a variety of combination reactions, AEDs can affect the anticoagulant effect of warfarin, so we need to consider the interaction between drugs and avoid adverse reactions.
ObjectivesTo systematically review the risk of arterial ischemic and metabolic adverse events in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were searched to collect clinical trials, observational studies and case reports of adverse events in CML patients treated with TKIs from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 22 studies involving 4 223 patients were included. The incidence rates of ischemic heart disease in any grade were 2 per 100 patient-years (95%CI 2 to 3) for nilotinib, and 0 per 100 patient-years (95%CI 0 to 3) for imatinib. The incidence of ischemic heart disease in grade 3 or 4 was 1 per 100 patient-years (95%CI 0 to 2) for nilotinib. The incidence of peripheral arterial occlusive disease in any grade was 2 per 100 patient-years (95%CI 0 to 14) for nilotinib, and 0 per 100 patient-years (95%CI 0 to 2) for imatinib. The incidence of hypertension in any grade was 1 per 100 patient-years (95%CI 0 to 3) for nilotinib, and 44 per 100 patient-years (95%CI 27 to 71) for ponatinib. The incidence of hypertension in grade 3 or 4 was 2 per 100 patient-years (95%CI 0 to 15) for nilotinib, and 22 per 100 patient-years (95%CI 8 to 58) for ponatinib. The incidence of hyperlipidemia in any grade was 17 per 100 patient-years (95%CI 5 to 59) for nilotinib. The incidence of hyperglycemia in any grade was 11 per 100 patient-years (95%CI 9 to 15) for nilotinib, 2 per 100 patient-years (95%CI 1 to 4) for imatinib, 1 per 100 patient-years (95%CI 0 to 5) for dasatinib, and 19 per 100 patient-years (95%CI 19 to 20) for bosutinib. The incidence of hyperglycemia in grade 3 or 4 was 4 per 100 patient-years (95%CI 3 to 5) for nilotinib, and 1 per 100 patient-years (95%CI 1 to 2) for bosutinib.ConclusionsPatients treated with nilotinib have a greater possibility of ischemic heart and peripheral arterial occlusive disease compared with patients treated with imatinib. Patients treated with ponatinib have a high incidence rate of hypertension, and patients treated with nilotinib have a high incidence rate of hyperlipidemia. Patients treated with bosutinib and nilotinib have higher risk of hyperglycemia compared with patients treated with imatinib or dasatinib.
目的 观察酒石酸布托啡诺与芬太尼合用于术后静脉自控镇痛（PCIA）的效果及最佳混合比例。 方法 2010年8月－2011年1月100例妇科手术患者，随机分为5组，每组20例。均全身麻醉术后采用负荷量+持续背景剂量+PCIA方案镇痛。根据不同配方分为F组：芬太尼1 mg+生理盐水至100 mL；B组：酒石酸布托啡诺10 mg+生理盐水至100 mL；BFⅠ组：芬太尼0.6 mg+酒石酸布托啡诺3 mg+生理盐水至90 mL；BFⅡ组：芬太尼0.5 mg+酒石酸布托啡诺5 mg+生理盐水至100 mL；BFⅢ组：芬太尼0.3 mg+酒石酸布托啡诺6 mg+生理盐水至90 mL。观察术后各时点视觉模拟评分（VAS）及镇静评分，患者满意度以及不良反应情况。 结果 术后早期BFⅢ组和B组VAS评分大于F组；镇静评分B组大于F组；B组满意度优良率小于其余各组；恶心呕吐发生率F组高于BFⅠ组及BFⅡ组。 结论 酒石酸布托啡诺和芬太尼合用于PCIA，镇痛效果确切，不良反应发生率低。推荐配比：BFⅠ组和BFⅡ组。