Analysis of 320 reports of adverse drug reactions involving the central nervous system in a tertiary hospital
某三甲医院320例涉及中枢神经系统的药品不良反应报告分析

摘要

目的 回顾分析笔者所在医院中枢神经系统药品不良反应（ADR）发生的特点和规律，为临床安全合理用药提供参考。方法 选取2020年1月至2024年12月笔者所在医院上报至药品不良反应监测系统中的报告，从中筛选出320例中枢神经系统ADR报告进行统计分析。结果 320例中枢神经系统ADR报告中，男性比例（164例，51.25%）略多于女性（156例，48.75%）；静脉给药途径（178例，55.62%）是导致ADR发生的主要给药途径；ADR发生的时间在用药1h-1d（101例，31.56%）出现最多，多数（249例，77.80%）ADR症状在当天缓解或消失；主要涉及的药品类型为抗感染药（151例，47.19%），以喹诺酮类（72例，47.68%）为主；主要临床表现是头痛头晕头胀（228例，71.25%）；ADR级别主要是一般282例，88.12%；ADR主要由医师上报；预后方面，痊愈152例（47.50％），无死亡病例。结论 临床工作中需要注意中枢神经系统ADR发生的特点和规律，要特别重视抗感染药的影响，合理使用抗菌药物，加强ADR监测工作，增强医护人员对ADR的认识和上报意识，减少ADR的发生，确保临床用药安全合理。

Abstract

Objective To retrospectively analyze the characteristics and patterns of adverse drug reactions (ADRs) involving the central nervous system (CNS) in our hospital, providing a reference for safe and rational clinical drug use.
Methods ADR reports submitted to the hospital's ADR monitoring system from January 2020 to December 2024 were selected, and 320 CNS ADR reports were screened for statistical analysis.
Results Among the 320 CNS ADR reports, the proportion of males (164 cases, 51.25%) was slightly higher than that of females (156 cases, 48.75%). The main route of administration causing ADRs was intravenous injection (178 cases, 55.62%). The most common time for ADR onset was within 1 hour to 1 day after medication (101 cases, 31.56%), and most ADR symptoms (249 cases, 77.80%) relieved or disappeared on the same day. The main types of drugs involved were anti-infective drugs (151 cases, 47.19%), predominantly quinolones (72 cases, 47.68%). The primary clinical manifestations were headache, dizziness, and head fullness (228 cases, 71.25%). Most ADRs were of mild severity (282 cases, 88.12%) and were mainly reported by physicians. In terms of prognosis, 152 cases (47.50%) recovered, with no deaths reported.
Conclusion   Attention should be paid to the characteristics and patterns of CNS ADRs in clinical practice, with particular focus on the effects of anti-infective drugs. Rational use of antimicrobial agents, strengthened ADR monitoring, and enhanced awareness and reporting of ADRs among healthcare workers are essential to reduce ADR occurrences and ensure safe and reasonable clinical drug use.