Grönroos P E, Irjala K M, Selén G P, Forsström J J
Central Laboratory, Turku University Central Hospital, Finland.
Int J Clin Monit Comput. 1997 Nov;14(4):255-9. doi: 10.1007/BF03356571.
Many drugs are known to affect the results of laboratory tests. This may cause problems in the interpretation of clinical laboratory data and lead to wrong diagnoses, unnecessary further tests and additional costs. A computerized monitoring system of potential drug effects on laboratory tests was developed in Turku University Central Hospital. In the present study the incidence and nature of potentially interfering drug effects in thyroid function diagnostics was examined in order to ease the clinical implementation of the system.
Computerized medication data of 754 hospital in-patients whose thyroid function was tested were combined with a knowledge base of drug effects on laboratory tests. All medications that potentially affected the levels of serum thyrotropin or free thyroxin in study patients were detected.
40% (292 of 735) of the patients tested for thyrotropin and 32% (107 of 333) of the patients tested for free thyroxin received potentially interfering medication during the tests. The most common potentially interfering medication was acetylsalicylic acid, but the daily dose was usually low, 100 mg.
The coincidence of potentially interfering medication and thyroid function tests was substantial. On-line hints of drug effects on thyroid function tests might offer valuable decision support to clinicians, but further development of the system is needed to regulate the prevalence of warnings into a clinically optimal level.
已知许多药物会影响实验室检测结果。这可能会在临床实验室数据解读方面引发问题,导致错误诊断、不必要的进一步检测以及额外费用。图尔库大学中心医院开发了一个关于药物对实验室检测潜在影响的计算机化监测系统。在本研究中,对甲状腺功能诊断中潜在干扰药物作用的发生率和性质进行了检查,以便于该系统在临床中的应用。
将754例接受甲状腺功能检测的住院患者的计算机化用药数据与药物对实验室检测影响的知识库相结合。检测出所有可能影响研究患者血清促甲状腺素或游离甲状腺素水平的药物。
在接受促甲状腺素检测的患者中,40%(735例中的292例)以及在接受游离甲状腺素检测的患者中,32%(333例中的107例)在检测期间服用了可能产生干扰的药物。最常见的可能产生干扰的药物是乙酰水杨酸,但日剂量通常较低,为100毫克。
可能产生干扰的药物与甲状腺功能检测的巧合情况较为显著。关于药物对甲状腺功能检测影响的在线提示可能会为临床医生提供有价值的决策支持,但需要对该系统进行进一步开发,以便将警告发生率调整到临床最佳水平。