| ABSTRACT Objective: To investigate risk factors of anaphylactic shock (AS) caused by dextran 40 and amino acid injection, to provide a reference for clinical safety medication. Methods:Among 278 cases of adverse drug reaction (ADR) induced by Dextran 40 and Amino Acid Injection were collected from our hospital from January of 2010 to November of 2018, which divided into AS group (45 cases) and non AS group (233 cases) according to AS diagnostic criteria. Relevant factors such as age, gender, allergic history, serum total protein level, surgical treatment, renal function, liver function, primary disease, daily dose, cumulative medication time, and combination medication were analyzed by univariate (χ2 test) and multiple factors (Logistic regression). Results:AS was one of the serious ADR of dextran 40 and amino acid injection, it's incidence was 16.19% in this investigation. Univariate analysis showed that the patient’s age, serum total protein levels, perioperative period, serum creatinine clearance, medication with AS. And multiple factors analysis showed that prolong administration (>5 d), hypoproteinemia (＜60 g·L-1), aging (≥65 years), renal insufficiency (≤30 ml·min-1) and surgical treatment were independent risk factors of AS, and the OR values respectively were 2.68, 2.39, 2.12, 2.02 and 1.89. The 45 cases of AS patients were stopped drug, and given epinephrine, dexamethasone, promethazine and so on, meanwhile given timely interventions such as oxygen intake and rehydration, at last the 44 patients were cured and discharged. One patient died and 2.22% of patients with AS. Conclusion:Clinical practice should focus on patients with independent risk factors to ensure clinical safe use of dextran 40 and amino acidinjection. |
