本文選題：抗結(jié)核藥物不良反應(yīng) + 發(fā)生率　； 參考：《新疆醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:了解烏魯木齊市抗結(jié)核藥物不良反應(yīng)(Adverse Drug Reactions,ADRs)的發(fā)生情況,并探討其影響因素。為早期識(shí)別和預(yù)防ADRs的發(fā)生提供科學(xué)依據(jù)。方法:本研究采用橫斷面研究設(shè)計(jì)方法,選取2013年1月至2014年12月在新疆烏魯木齊市結(jié)核病防治定點(diǎn)醫(yī)院接受治療的肺結(jié)核患者作為研究對(duì)象。在患者開始治療后的第0,2,5,6月末,對(duì)其進(jìn)行肝、腎功能及血常規(guī)檢測(cè),并記錄服藥期間出現(xiàn)的不良反應(yīng)情況。收集并整理研究對(duì)象的相關(guān)資料(病歷資料、服藥單記錄、化驗(yàn)單及ADRs等相關(guān)信息)。按照ADRs判斷標(biāo)準(zhǔn)分為ADRs組及正常組,采用單因素及多因素logisistic回歸探討ADRs可能的相關(guān)因素。結(jié)果:ADRs的總發(fā)生率為60.62%。多因素Logistic回歸顯示:與漢族相比,維吾爾族、哈薩克族、其他少數(shù)民族發(fā)生ADRs危險(xiǎn)較低;與轉(zhuǎn)診相比,追蹤、因癥就診、因癥推薦發(fā)生ADRs危險(xiǎn)較低;與強(qiáng)化期督導(dǎo)相比,全程管理發(fā)生ADRs危險(xiǎn)較低。與未服用固定劑量復(fù)合制劑(Fixed-Dose Combination,FDC)患者相比,服用FDC患者容易發(fā)生ADRs。復(fù)治患者、HIV抗體檢測(cè)陽(yáng)性患者及既往有卡介苗接種史、肝病史、過(guò)敏史患者在抗結(jié)核治療期間較易發(fā)生ADRs。結(jié)論:在抗結(jié)核治療過(guò)程中,對(duì)復(fù)治患者、既往有肝病史、藥物過(guò)敏史、HIV抗體檢測(cè)陽(yáng)性等高危患者,在接受抗結(jié)核治療的強(qiáng)化期(前兩個(gè)月內(nèi))密切檢測(cè)其肝、腎功能,將血常規(guī)檢查也加入常規(guī)檢測(cè)項(xiàng)目中,詳細(xì)記錄并觀察肺結(jié)核患者在治療期間不良反應(yīng)發(fā)生情況,以便及時(shí)了解ADRs的發(fā)生和采取相應(yīng)措施。
[Abstract]:Objective: to investigate the occurrence of Adverse drug reactions (ADRs) in Urumqi and its influencing factors. To provide scientific basis for early identification and prevention of ADRs. Methods: a cross-sectional study design method was used to select pulmonary tuberculosis patients who received treatment from January 2013 to December 2014 in a designated hospital for tuberculosis control in Urumqi, Xinjiang. The liver, kidney function and blood routine examination were performed at the end of the 5th month after the patients began treatment, and the adverse reactions during the treatment were recorded. Collect and organize the data of the subjects (medical records, medication records, laboratory sheets and ADRs, etc.). According to ADRs criteria, ADRs were divided into ADRs group and normal group. Univariate and multivariate logisistic regression was used to explore the possible related factors of ADRs. Results the total incidence of 7% ADRs was 66. 62%. Multivariate logistic regression analysis showed that the risk of ADRs in Uygur, Kazak and other minority nationalities was lower than that in Han nationality, the risk of ADRs was lower than that of referral, and the risk of ADRs was lower than that of referral, and the risk of ADRs was lower than that of intensive supervision. The risk of ADRs in the whole course of management was lower. Patients taking FDC were more likely to develop ADRsthan those who did not take Fixed-Dose Combination- FDC (Fixed-Dose Combination- FDC). Patients with positive HIV antibody test and previous history of BCG vaccination, liver disease and allergic history were more likely to develop ADRsduring anti-tuberculosis treatment. Conclusion: in the course of anti-tuberculosis treatment, the liver and kidney functions of patients with recurrent treatment, with history of liver disease, history of drug allergy and HIV antibody detection were closely examined during the intensive period (within the first two months) of anti-tuberculosis treatment. Blood routine examination was added to routine examination item to record and observe the occurrence of adverse reactions of pulmonary tuberculosis patients during treatment in order to understand the occurrence of ADRs in time and take corresponding measures.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R52

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