| 闫阔,张楠,陆红柳,杨慧鹃,李桃园,夏文斌.瑞格列奈与氯吡格雷相互作用致低血糖的风险评估[J].中国药事,2021,35(7):768-775 |
| 瑞格列奈与氯吡格雷相互作用致低血糖的风险评估 |
| Risk Assessment of Hypoglycemia Induced by the Interaction between Repaglinide and Clopidogrel |
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| DOI：10.16153/j.1002-7777.2021.07.007 |
| 中文关键词: 氯吡格雷 瑞格列奈 低血糖 药物相互作用 |
| 英文关键词: Clopidogrel Repaglinide hypoglycemia drug-drug interaction |
| 基金项目:首都临床特色应用研究项目(编号 Z181100001718125) |
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| 中文摘要: |
| 目的：评估瑞格列奈与氯吡格雷相互作用导致低血糖发生的风险，为临床合理用药提供参考。 方法：回顾分析2014年1月-2019年9月北京市垂杨柳医院住院患者使用瑞格列奈的所有病例，参照药品不良反应评价标准，评估两药相互作用致低血糖发生的可能性，统计低血糖发生率，并对影响因素进行多因素Logistic回归分析。结果：2014年1月-2019年9月，共有瑞格列奈病例573例，根据纳入/排除标准，最终纳入研究433例，其中与氯吡格雷合用的病例157例，占比36.26%。单用瑞格列奈的低血糖发生率为7.97%，与氯吡格雷合并用药的低血糖发生率为25.48%；其差异具有统计学意义(P＜0.05)。在与氯吡格雷合并用药的病例中，低血糖发生时间为1~12天，平均(4.18±2.84)天，且瑞格列奈日剂量 ＞4 mg时，低血糖风险显著增加(P＜0.05)。结论：两药合并使用存在有临床意义的相互作用，应避免合用；必须合用时，应谨慎合用，并根据需要调整瑞格列奈剂量，密切监测血糖和低血糖症状，保障用药安全。 |
| 英文摘要: |
| Objective: To provide references for rational drug use in clinical practice by evaluating the risk of hypoglycemia induced by the interaction between Repaglinide and Clopidogrel. Methods: All the cases of patients admitted to Beijing Chuiyangliu hospital who used Reaglinide from January, 2014 to September, 2019 were retrospectively analyzed , and the possibility of hypoglycemia caused by the interaction between the two drugs by referring to the evaluation standards of adverse drug reactions was assessed. The incidence of hypoglycemia was statistically analyzed, and multivariate logistic regression analysis of the influencing factors was performed. Results: From January, 2014 to September, 2019, a total of 573 cases of Repaglinide were analyzed. According to the inclusion/exclusion criteria, 433 cases were included in the final study, among which 157 cases were combined with Clopidogrel, accounting for 36.26%. The incidence of hypoglycemia was 7.97% with Reaglinide alone and 25.48% with the combination of Reaglinide and Clopidogrel. The difference was statistically significant (P＜ 0.05). In patients treated with Clopidogrel, the onset time of hypoglycemia was 1-12 days, with an average of (4.18±2.84) days, and the risk of hypoglycemia was significantly increased (P＜0.05) with the daily Regrelinidedose of ＞4 mg. Conclusion: The combined use of the Repaglinide and Clopidogrel has clinical significance of interaction, thus these two drugs should be avoided in combination; when they are necessary to be used together, they should be used with care. The dose of Reaglinide should be adjusted as needed, and the blood glucose level and the symptoms of hypoglycemia should be closely monitored, to ensure the safety of clinical medication. |
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