摘要
目的分析应用血管紧张素转换酶抑制剂(ACEI)的不良反应特征。方法选取高邮中医医院心内科于2011年5月~2016年5月收治的应用ACEI治疗后发生不良反应的患者412例,其中男性243例,女性169例,年龄18~75岁,平均(52.5±4.9)岁。回顾性分析入组患者的年龄、用药情况、不良反应表现、发生时间、治疗情况等。结果本组患者中,年龄<30岁和30~39岁比例较小,主要分布在40~49岁、50~59岁、60~69岁、≥70岁。卡托普利致不良反应的比例最高,为77.91%;其次为贝那普利与依那普利分别为8.74%、7.04%;雷米普利、福辛普利、培哚普利、赖诺普利致不良反应比例较低,分别为2.91%、1.46%、1.46%和0.49%。ACEI不良反应的临床表现以喘憋、咳嗽、咽部不适为主,主要累及呼吸系统,占65.05%;7.77%的患者不良反应累及皮肤,临床表现为皮疹、水肿、炎症、溃疡等;7.77%累及泌尿生殖系统,有尿频、蛋白尿、血尿等表现。另外还有7.04%累及心血管系统,4.85%累及血液系统,4.85%累及消化系统,2.18%累及关节肌肉。412例患者中,26例在用药当天即出现不良反应,占6.31%,386例在用药第2 d后出现不良反应,占93.69%,不良反应的平均出现时间为(16.9±10.4)d。患者经对症治疗或停药处理后,绝大多数症状明显缓解并逐渐消失,其中30例患者复用药物后再次发生相同不良反应。结论应用ACEI发生的不良反应表现多样、原因复杂,多数需对症治疗或停药才可消失,临床用药过程中要密切监测不良反应,提高用药安全性。
Objective To analyze the features of adverse reactions after treatment with angiotensin converting enzyme inhibitor(ACEI).Methods The patients(n=412,male243,female169,aged from18to75and average age=52.5±4.9)with adverse reactions after treatment with ACEI were chosen from the Department of Cardiology in Gaoyou Hospital of Chinese Medicine from May2011to May2016.The age,drug administration,manifestations and occurrence time of adverse reactions and treatment conditions were retrospectively analyzed in all patients.Results The percentages of patients aged<30and from30to39were lower,and patients’ages mainly distributed from40to49,50to59,60to69and over70.The proportion of adverse reactions induced by captopril was the highest(77.91%),and that by benazepril was8.74%and by enalapril was7.04%.The proportions of adverse reactions induced by ramipril(2.91%),fosinopril(1.46%),perindopril(1.46%)and lisinopril(0.49%)were lower.The clinical manifestations of adverse reactions induced by ACEI were mainly wheezing,coughing and throat discomfort,and mainly involved the respiratory system,accounting for65.05%.The adverse reactions involved skin in7.77%of patients,and clinical manifestations included rash,edema,inflammation and ulcer.Theadverse reactions involved the urogenital system in7.77%of patients,and clinical manifestations included frequent urination,proteinuria and hematuresis,and involved the cardiovascular system in7.04%of patients,blood system in4.85%,digestive system in4.85%,and joints and muscle in2.18%.Among412patients,there were26(6.31%)with adverse reactions at medication day and386(93.69%)with adverse reactions after2d,and the average time was(16.9±10.4)d.The symptoms of adverse reactions were relieved and disappeared in the most of patients after treatment or stopping medication,while there were30patients had the same adverse reactions after re-medication.Conclusion The manifestations of adverse reactions induced by ACEI are multiple and causes are complex,which will disappear after symptomatic treatment or stopping medication.The adverse reactions should be closely monitored in clinic for improving safety of medication.
作者
徐朝飞
Xu Chaofei(Gaoyou Hospital of Chinese Medicine, Gaoyou 225600, China)
出处
《中国循证心血管医学杂志》
2017年第8期969-971,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
血管紧张素转换酶抑制剂
心内科
不良反应
合理用药
Angiotensin converting enzyme inhibitor
Department of cardiology
Adverse reactions
Rational drug administration
