Chan T Y
Department of Clinical Pharmacology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Pharmacoepidemiol Drug Saf. 1997 Mar;6(2):89-92. doi: 10.1002/(SICI)1099-1557(199703)6:2<89::AID-PDS261>3.0.CO;2-8.
The sulphamethoxazole component of co-trimoxazole can cause clinically significant haemolysis, particularly in subjects with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Erythrocyte G6PD deficiency is common amongst Southern Chinese in Hong Kong, affecting 4.4% of the males and 0.35% of the females. The incidence of this complication amongst the 0.9 million subjects aged > or =15 years residing in the New Territories East during a 12-month period in 1994-95 was determined. A search of the computerized medical record system in our medical unit at the Prince of Wales Hospital, the sole general hospital for the region, was used to identify such cases. Of a total of 46 patients having a diagnosis ICD code of 282 (hereditary haemolytic anaemias), 283 (acquired haemolytic anaemias) or 960 (poisoning by antibiotics), none had haemolysis due to co-trimoxazole. Based on the consumption of co-trimoxazole tablets in the Prince of Wales Hospital, it was estimated that 2163 subjects aged > or =15 years received this drug from the hospital alone. The number of subjects who were treated in the community was not known but experience in Sweden suggested that there could be 2-3 times more. Severe haemolysis due to co-trimoxazole appears to be exceedingly rare in Hong Kong as in the United States and Sweden.
复方新诺明中的磺胺甲恶唑成分可导致具有临床意义的溶血，尤其是在葡萄糖-6-磷酸脱氢酶（G6PD）缺乏的患者中。红细胞G6PD缺乏在香港的中国南方人中很常见，男性患病率为4.4%，女性为0.35%。本研究确定了1994 - 1995年12个月期间居住在新界东部年龄≥15岁的90万人群中该并发症的发生率。我们检索了威尔士亲王医院医疗单位的计算机化病历系统，该医院是该地区唯一的综合医院，以此来确定此类病例。在总共46例诊断ICD编码为282（遗传性溶血性贫血）、283（获得性溶血性贫血）或960（抗生素中毒）的患者中，没有一例是由复方新诺明引起的溶血。根据威尔士亲王医院复方新诺明片的使用情况估计，仅在该医院就有2163名年龄≥15岁的患者使用了这种药物。在社区接受治疗的患者人数不详，但瑞典的经验表明可能是这个数字的2至3倍。与美国和瑞典一样，在香港，由复方新诺明引起的严重溶血似乎极为罕见。
