先天性心脏病患儿的药物相关副作用及相关危险因素：一项横断面研究
Drug-Related Side Effects and Contributing Risk Factors in Children With Congenital Heart Disease: A Cross-Sectional Study.
作者信息
Toni Esmaeel, Ayatollahi Haleh, Abbaszadeh Reza, Siahpirani Alireza Fotuhi
机构信息
Student Research Committee Iran University of Medical Sciences Tehran Iran.
Health Management and Economics Research Center, Health Management Research Institute Iran University of Medical Sciences Tehran Iran.
出版信息
Health Sci Rep. 2025 May 19;8(5):e70835. doi: 10.1002/hsr2.70835. eCollection 2025 May.
BACKGROUND AND AIMS
Children with congenital heart disease (CHD) often require complex pharmacotherapy for symptom management and complication prevention. However, their unique physiological profiles increase vulnerability to drug-related side effects. This study aimed to identify specialists' perspectives on drug-related side effects and associated risk factors in pediatric CHD patients.
METHODS
A cross-sectional study was conducted in 2024 involving 20 pediatric cardiologists and pediatric cardiology fellows. Data were collected using two 5-point Likert scale questionnaires assessing commonly prescribed drugs, observed side effects, and associated risk factors in pediatric CHD patients. Data were analyzed using student's -tests and descriptive statistics.
RESULTS
According to the findings, the most frequent side effects linked to common medications were hypokalemia (Furosemide; 4.5 ± 0.69), apnea (Prostaglandin E1; 4.5 ± 0.62), and bradycardia (Sotalol; 4.41 ± 0.51). Dosage and polypharmacy emerged as major risk factors, particularly for drugs like Digoxin and Heparin. Younger age, underlying health conditions, and specific drug combinations also increased the risk of side effects. The -test revealed significant associations between participants' demographics (sex, age, and work experience) and their perceptions of drug-related side effects and risk factors.
CONCLUSIONS
The findings emphasize the need for a personalized approach to pharmacotherapy in pediatric CHD patients, requiring careful drug selection, dose optimization, and enhanced monitoring strategies. Drug-related side effects highlight the importance of implementing clinical decision support systems, routine therapeutic drug monitoring, and individualized dosing adjustments to mitigate risks. Future research should prioritize longitudinal studies to establish causality relationships, optimize treatment protocols, and improve medication safety in this vulnerable population.
背景与目的
先天性心脏病（CHD）患儿常需进行复杂的药物治疗以控制症状和预防并发症。然而，他们独特的生理特征增加了药物相关副作用的易感性。本研究旨在确定专家对小儿CHD患者药物相关副作用及相关危险因素的看法。
方法
2024年进行了一项横断面研究，纳入20名儿科心脏病专家和儿科心脏病学研究员。使用两份5级李克特量表问卷收集数据，评估小儿CHD患者常用药物、观察到的副作用及相关危险因素。数据采用学生t检验和描述性统计进行分析。
结果
根据研究结果，与常用药物相关的最常见副作用为低钾血症（呋塞米；4.5±0.69）、呼吸暂停（前列腺素E1；4.5±0.62）和心动过缓（索他洛尔；4.41±0.51）。剂量和联合用药成为主要危险因素，尤其是地高辛和肝素等药物。年龄较小、基础健康状况以及特定药物组合也增加了副作用风险。t检验显示参与者的人口统计学特征（性别、年龄和工作经验）与他们对药物相关副作用和危险因素的认知之间存在显著关联。
结论
研究结果强调小儿CHD患者药物治疗需要个性化方法，需要谨慎选择药物、优化剂量并加强监测策略。药物相关副作用凸显了实施临床决策支持系统、常规治疗药物监测和个体化剂量调整以降低风险的重要性。未来研究应优先进行纵向研究，以建立因果关系、优化治疗方案并提高这一脆弱人群的用药安全性。
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