中国药物警戒 ›› 2022, Vol. 19 ›› Issue (9): 1030-1034.
DOI: 10.19803/j.1672-8629.2022.09.21

• 安全与合理用药 • 上一篇    下一篇

基于Logistic回归分析格列美脲不良反应影响因素及其对治疗2型糖尿病有效性的影响

杨柳1, 石凤华2,*, 马丽娟3   

  1. 1菏泽市中医医院药剂科,山东 菏泽274000;
    2菏泽市中医医院西药科,山东 菏泽274000;
    3菏泽市中医医院内分泌科,山东 菏泽274000
  • 收稿日期:2021-01-14 出版日期:2022-09-15 发布日期:2022-09-16
  • 通讯作者: *石凤华,女,本科,主管药师,临床药学。E-mail：shifenghua.2008@163.com
  • 作者简介:杨柳,女,硕士,主管药师,内分泌临床药学。
  • 基金资助:
    山东省优秀中青年科学家科研奖励基金（BS2018SW413）

Logistic regression analysis of influencing factors of adverse drug reaction of glimepiride and their effect on treatment of T2DM

YANG Liu1, SHI Fenghua2,*, MA Lijuian3   

  1. 1Department of Pharmacy, Heze Hospital of Traditional Chinese Medicine, Heze Shandong 274000, China;
    2Department of Western Medicine, Heze Hospital of Traditional Chinese Medicine, Heze Shandong 274000, China;
    3Department of Endocrinology, Heze Hospital of Traditional Chinese Medicine, Heze Shandong 274000, China
  • Received:2021-01-14 Online:2022-09-15 Published:2022-09-16

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摘要： 目的 分析格列美脲药品不良反应（ADR）影响因素及其对治疗2型糖尿病（T2DM）有效性的影响。方法 前瞻性选择2018年6月1日至2020年6月30日某院收治的T2DM患者123例,均接受格列美脲治疗,统计ADR发生率,并根据有无ADR分为ADR组与无ADR组,比较2组基线资料、血糖指标水平[空腹血糖（FBG）、餐后2 h血糖（2hBG）、糖化血红蛋白（HbA1c）]、胰岛β细胞功能[胰岛素抵抗指数（HOMA-IR）、胰岛β细胞功能指数（HOMA-β）]、血脂[甘油三脂（TG）、总胆固醇（TC）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）],分析格列美脲ADR影响因素,并比较2组治疗有效性。结果 123例T2DM患者接受格列美脲治疗后,29例（23.58%）患者发生ADR;年龄>70岁、饮酒、超适应证用药、单次给药剂量2~4 mg、治疗不依从、用药时间长是格列美脲发生ADR的独立危险因素（P<0.05）;ADR组总有效率72.41%（21/29）低于无ADR组92.55%（87/94）（P<0.05）。结论 年龄>70岁、饮酒、单次给药剂量大、用药时间长的格列美脲ADR风险高,应重点关注,而提高治疗依从性、加强适应证用药监管等措施,有助于减少格列美脲ADR,为临床合理调整用药、获得满意治疗效果提供参考指导。

关键词: 格列美脲, 药品不良反应, 2型糖尿病, 单次给药剂量, 有效性

Abstract: Objective To analyze the influencing factors of adverse drug reaction (ADR) of glimepiride and their effect on the efficacy of treatment of type 2 diabetes mellitus (T2DM). Methods From June 1, 2018 to June 30, 2020, 123 patients with T2DM admitted to our hospital were prospectively selected and treated with glimepiride. The incidence of ADR was recorded, and these patients were divided into the ADR group and non-ADR group according to the presence or absence of ADR. The baseline data, blood glucose levels [fasting blood glucose (FBG), 2 h postprandial blood glucose (2hBG), hemoglobin A1c (HbA1c)], pancreatic β cell function [homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment for β-cell function (HOMA-β)] and blood lipids [triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C)] were compared between the two groups. Factors affecting the ADR of glimepiride were analyzed, and the efficacy of treatment was compared between the two groups. Results After the 123 patients with T2DM were treated with glimepiride, ADR occurred in 29 of them (23.58%). Age over 70, alcohol consumption, off-label medications, single doses of 2~4 mg, lack of compliance, and long medication were independent risk factors for ADR of glimepiride (P<0.05). The total effective rate of the ADR group was 72.41% (21/29), which was lower than 92.55% (87/94) in the non-ADR group (P<0.05). Conclusion The risk of ADR associated with glimepiride is high among those who are over 70 years old, drink alcohol, take large single doses, and take this drug for a long time. Such measures such as improving compliance and strengthening the supervision of indications can help reduce the ADR of glimepiride.

Key words: glimepiride, adverse drug reaction, type 2 diabetes mellitus, single dose, effectiveness

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