基于logistic分析法的注射用血凝酶致过敏性休克研究

摘要

探讨注射用凝血酶致过敏性休克的影响因素,为临床安全用药提供科学依据.本文通过检索收集中外文献中关于注射用血凝酶所致不良反应的病例报道,对注射用血凝酶致过敏性休克的临床特点及影响因素进行Logistic回归统计分析.本研究共收集到87篇文献,总计108个病例(过敏性休克病例68例).单因素logistic回归分析结果显示:过敏性体质,日剂量,首次给药,合并麻醉,给药后时间,疗程与过敏性休克发生率呈明显相关(P＜0.05).将以上6个因素纳入logistic多因素逐步回归分析排除混杂因素影响,结果显示:过敏体质((P=0.048,OR=8.242),合并麻醉(P=0.024,OR=22.675),给药后时间((P=0.006,OR=20.255)是注射用血凝酶发生过敏性休克的独立危险因素.结果 发现,临床医师应该注意注射用血凝酶致过敏性休克的高危因素如过敏体质、合并麻醉、用药后时间等.临床药师应注意加强药学监护提高用药安全性.%In the present study,we aimed to explore the influencing factors of anaphylactic shock caused by hemocoagulase for injection and to provide a scientific basis for clinical safe medication.The cases reports on the adverse reactions induced by hemocoagulase for injection were collected in Chinese and foreign literatures.The clinical characteristics and influencing factors of anaphylactic shock induced by hemocoagulase for injection were evaluated by logistic regression analysis.In this study,87 articles including 108 cases (68 cases of anaphylactic shock) were collected.Univariate logistic regression indicated that allergic constitution,daily dose,combined anesthesia,first drug delivery,post-dose time and course of treatment were positively associated with the incidence of anaphylactic shock caused by hemocoagulase for injection (P＜0.05).The six above-mentioned factors were included in the multivariate logistic stepwise regression analysis to exclude the effects of confounding factors,and the results suggested that allergic constitution (P =0.048,OR =8.242),combined anesthesia (P =0.024,OR =22.675) and post-dose time (P =0.006,OR =20.255) were associated with the incidence of anaphylactic shock caused by hemocoagulase for injection.The clinicians should pay much more attention to risk factors that may cause anaphylactic shock,such as allergic constitution,combined anesthesia and post-dose time.The clinical pharmacists should strengthen pharmaceutical monitoring and improve the safety of medication.