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基于软件评价左甲状腺素钠的药物相互作用及临床数据分析

Based on Software Evaluation on Drug drug Interaction and Clinical Data of Levothyroxine Sodium

DOI：

中文关键词: 左甲状腺素钠药物相互作用软件合理用药

英文关键词:Levothyroxine sodium Drug interaction Software evaluation Rational drug use

基金项目:上海交通大学医学院医院药学科研基金（编号：JDYX2017QN003），上海交通大学中央高校基本科研业务费资助（编号：17JCYB11），上海医院药学科研（编号：2015 YY 01 20），上海市卫生计生系统重要薄弱学科建设计划（编号2016ZB0304）

作者	单位
施芳红1  李浩2 崔敏1 刘晓琰1	1.上海交通大学医学院附属仁济医院药剂科上海 200127；2.上海交通大学医学院附属上海儿童医学中心药剂科

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中文摘要:

摘要目的：通过药物相互作用软件（Lexi InteractionTM）评价左甲状腺素钠（L T4）的药物相互作用（drug drug interactions，DDIs），结合临床数据进行分析，为临床合理用药提供参考。 方法：采用Lexi Interaction TM软件从理论角度评价L T4的DDIs，同时结合临床相关数据，分析目前临床常出现的DDIs、影响及应采取的措施。结果：通过Lexi Interaction TM软件共筛选出L T4相关的DDIs 36组，其中B级4组，C级16组，D级14组，X级2组。其中以降低L T4的疗效为主（30组，83.3%），还包括增加L T4疗效（2组，5.6%）及改变其他药物的疗效及不良反应（4组，11.1%）。共分析患者98例，其中有DDIs的占69.4%（68例），同时存在2组DDIs的患者占48.0%（47例），以合用钙盐和铁盐为主要表现，2组以下占21.4%（21例），以合用钙盐为主要表现。且使用L T4的患者多数为甲状腺减退患者，同时合并多种疾病。〖HTH〗结论：〖HTK〗L T4的DDIs以D、C级表现为主，大多数为降低L T4的疗效，临床上DDIs主要体现为联用钙盐和铁盐，因此对于临床合并疾病多，合并用药多的患者，使用L T4时应将影响药物错时服用，以减少其影响。

英文摘要:

ABSTRACT Objective:To evaluate the interaction of levothyroxine sodium (L T4) by drug drug interactions (DDIs) software (Lexi InteractionTM) and analyze clinical data to provide reference for clinical rational drug use. Methods:Lexi InteractionTM software was used to evaluate the DDIs of levothyroxine sodium from a theoretical perspective. Clinical interaction data were combined to analyze the current clinical interactions, impacts, and measures to be taken. Results:A total of 36 DDIs related to levothyroxine sodium were screened out by software. Among them, four were in group B, 16 in group C, 14 in group D, and 2 in group X. Among them, the efficacy of L T4 was mainly reduced (30, 83.3%). It also included an increase in L T4 efficacy (2, 5.6%) and changes in the efficacy and adverse reactions of other drugs (4, 11.1%). A total of 98 patients were analyzed, of which DDIs accounted for 69.4% (68/98) and 2 or more patients accounted for 48.0% (47/98). The combination of calcium and iron salt were the main manifestation. It takes accounting for 21.4% (21/98) of the 2 or less, with calcium salt as the main performance. Most of the patients who used L T4 were hypothyroidism patients and had multiple diseases at the same time. Conclusion:The drug interactions of L T4 were dominated by D and C grades. Most of them had the effect of lowering L T4. Clinically, DDIs were mainly expressed as calcium salt and iron salt. Therefore, there were many clinically combined diseases and more drugs were used together. In patients, the use of L T4 and other drugs should take in different times thus may reduce its effects.

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