Objective To analyze the occurrence and influencing factors of hypertension and hypokalemia caused by magnesium isoglycyrrhizinate injection, and to provide reference for clinical safe medication.

Methods  The medical records of inpatients received magnesium isoglycyrrhizinate injection therapy in The Second Affiliated Hospital, Xi’an Jiaotong University from January to June 2022 were collected and analyzed retrospectively. The incidence and occurrence characteristics of  hypertension and hypokalemia caused by magnesium isoglycyrrhizinate injection were recorded, and the influencing factors were analyzed.

Results  Totally 41 cases of hypertension occurred in 300 cases using magnesium isoglycyrrhizinate injection, the incidence rate was 13.67%. Multivariate logistic regression analysis showed that patients with older age (OR=1.028, 95%CI 1.001 to 1.058, P=0.049), higher body mass index (OR=1.435, 95%CI 1.226 to 1.681, P﹤0.001) and longer course of using magnesium isoglycyrrhizinate injection (OR=1.304, 95%CI 1.158 to 1.467, P﹤0.001) may be more likely to induce hypertension when using magnesium isoglycyrrhetate injection. Totally 29 cases of hypokalemia occurred, the incidence rate was 9.67%.  Multivariate logistic regression analysis showed that age (OR=1.037, 95%CI 1.003 to 1.072, P=0.033), daily dose of magnesium isoglycyrrhizinate injection (OR=1.024, 95%CI 1.005 to 1.043, P=0.011) and the course of using magnesium iso-glycyrrhizinate injection (OR=1.097, 95%CI 1.004 to 1.198, P=0.040) may be the in-fluencing factors of hypokalemia induced by magnesium isoglycyrrhizinate injection.  Conclusions  The blood pressure and electrolyte levels should be monitored regularly when magnesium isoglycyrrhizinate injection is used for clinical therapy. The patient with older age, higher the body mass index, longer the course of medication, the higher the probability of hypertension when using magnesium isoglycyrrhizate injection. The older the patient, the higher the daily dose and the longer the course of medication, the higher the prob-ability of hypokalemia when using magnesium isoglycyrrhizate injection.

1.宋红波, 刘茜, 赵辉, 等. 甘草酸铵类制剂中甘草酸差向异构体的分析[J]. 药物分析杂志, 2012, 32(5): 883-886. [Song HB, Liu Q, Zhao H, et al. Analysis of 2 epimers in ammonium glycyrrhizinate drugs[J]. Chinese Journal of Pharmaceutical Analysis, 2012, 32(5): 883-886.] DOI: 10.16155/j.0254-1793.2012.05.028.

2.Xu R, Xiao Q, Cao Y, et al. Comparison of the exposure of glycyrrhizin and its metabolites and the pseudoaldosteronism after intravenous administration of alpha- and beta-glycyrrhizin in rat[J]. Drug Res (Stuttg), 2013, 63(12): 620-624. DOI: 10.1055/s-0033-1349837.

3.刘思彤, 胡杨, 金月波, 等. 甘草酸制剂诱导重度低钾血症案例报道及分析[J]. 中国医药导刊, 2021, 23(10): 759-763. [Liu ST, Hu Y, Jin YB, et al. Glycyrrhizin-induced hypokalemia: a case report and literature re-view[J]. Chinese Journal of Medical Guide, 2021, 23(10): 759-763.] DOI: 10.3969/j.issn.1009-0959.2021.10.008.

4.周虹, 王华光, 于晓佳, 等. 236例异甘草酸镁注射液临床使用情况分析[J]. 中国药物应用与监测, 2015, 12(4): 235-239. [Zhou H, Wang HG, Yu XJ, et al. Analysis of the clinical application of magnesium isoglycyr-rhizinate injection in 236 patients[J]. Chinese Journal of Drug Application and Monitoring, 2015, 12(4): 235-239.] DOI: CNKI:SUN:YWYY.0.2015-04-015.

5.曹栋, 杜静, 刘华强. 复方甘草酸苷致横纹肌溶解1例[J]. 药物流行病学杂志, 2014, 23(1): 63-64. [Cao D, Du J, Liu HQ. Rhabdomyolysis caused by compound glycyrrhizin: a case report[J]. Chinese Journal of Phar-macoepidemiology, 2014, 23(1): 63-64.] DOI: 10.19960/j.cnki.issn1005-0698.2014.01.021.

6.张帆, 王彦, 陈菲, 等. 住院患者甘草酸制剂相关低钾血症主动监测系统的建立[J]. 药物不良反应杂志, 2016, 18(5): 347-351. [Zhang F, Wang Y, Chen F, et al. Establishment of an active monitoring system for glycyrrhizic acid preparation related hypokalemia in hospitalized patients[J]. Adverse Drug Reactions Journal, 2016, 18(5): 347-351.] DOI: 10.3760/cma.j.issn.1008-5734.2016.05.005.

7.田佳懿. 异甘草酸镁影响血钾平衡病例分析[J]. 中国临床医生杂志, 2017, 45(2): 114-116. [Tian JY. Case analysis of magnesium isoglycyrrhizinate affecting blood potassium balance[J]. Chinese Journal of Clinicians, 2017, 45(2): 114-116.] DOI: 10.3969/j.issn.2095-8552.2016.12.044.

8.周敏. 不同剂量异甘草酸镁治疗肝衰竭的疗效与不良反应观察[J]. 滨州医学院学报, 2016, 39(1): 39-40, 78. [Zhou M. Clinical study on different doses of magnesium isoglycyrrhizinate in the treatment of hepatic fail-ure[J]. Journal of Binzhou Medical University, 2016, 39(1): 39-40, 78.] https://d.wanfangdata.com.cn/periodical/bzyxyxb201601013.

9.罗佳, 伍奕, 曹丽芝, 等. 静滴异甘草酸镁致过敏性休克死亡1例[J]. 中国药师, 2015, 18(12): 2129-2130. [Luo J, Wu Y, Cao LZ, et al. One case died of anaphylactic shock caused by magnesium isoglycyrrhizate[J]. China Pharmacist, 2015, 18(12): 2129-2130.] DOI: 10.3969/j.issn.1008-049X.2015.12.036.

10.徐小燕, 吴骏, 杨勇. 异甘草酸镁注射液致输液反应1例[J]. 中国药师, 2012, 15(3): 399-400. [Xu XY, Wu J, Yang Y. Infusion reaction caused by magnesium isoglycyrrhizinate injection: a case report[J]. China Pharmacist, 2012, 15(3): 399-400.] DOI: 10.3969/j.issn.1008-049X.2012.03.044.

11.国家药品不良反应监测中心. 药品不良反应报告和监测工作手册[S]. 2012.

12.中国高血压防治指南修订委员会, 高血压联盟(中国), 中华医学会心血管病学分会, 等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1): 24-56. DOI: 10.3969/j.issn.1007-5410.2019.01.002.

13.中华医学会肾脏病学分会专家组. 中国慢性肾脏病患者血钾管理实践专家共识[J]. 中华肾脏病杂志, 2020, 36(10): 781-792. DOI: 10.3760/cma.j.cn441217-20200721-00139.

14.Xia Y, Shi H, Qian C, et al. Modulation of Gut Microbiota by magnesium isoglycyrrhizinate mediates enhancement of intestinal barrier function and amelioration of methotrexate-induced liver injury[J]. Front Immunol, 2022, 13: 874878. DOI: 10.3389/fimmu.2022.874878.

15.Jiang W, Liu J, Li P, et al. Magnesium isoglycyrrhizinate shows hepatoprotective effects in a cyclo-phosphamide-induced model of hepatic injury[J]. Oncotarget, 2017, 8(20): 33252-33264. DOI: 10.18632/oncotarget.16629.

16.Zou X, Wang Y, Peng C, et al. Magnesium isoglycyrrhizinate has hepatoprotective effects in an oxali-platininduced model of liver injury[J]. Int J Mol Med, 2018, 42(4): 2020-2030. DOI: 10.3892/ijmm.2018.3787.

17.王旭, 陈红斗, 刘瑞霞, 等. 两种甘草酸制剂辅助治疗慢性乙型肝炎的疗效与经济学比较[J]. 药物流行病学杂志, 2021, 30(7): 482-485. [Wang X, Chen HD, Liu RX, et al. Comparison of the efficacy and economics of two glycyrrhizic acid preparations in the adjuvant treatment of chronic hepatitis B[J]. Chinese Journal of Pharmacoepidemiology, 2021, 30(7): 482-485.] DOI: 10.19960/j.cnki.issn1005-0698.2021.07.011.

18.Kwon YJ, Son DH, Chung TH, et al. A review of the pharmacological efficacy and safety of licorice root from corroborative clinical trial findings[J]. J Med Food, 2020, 23(1): 12-20. DOI: 10.1089/jmf.2019.4459.

19.Yasue H, Itoh T, Mizuno Y, et al. Severe Hypokalemia, rhabdomyolysis, muscle paralysis, and respira-tory impairment in a hypertensive patient taking herbal medicines containing licorice[J]. Intern Med, 2007, 46(9): 575-578. DOI: 10.2169/internalmedicine.46.6316.

20.Makino T. Exploration for the real causative agents of licorice-induced pseudoaldosteronism[J]. J Nat Med, 2021, 75(2): 275-283. DOI: 10.1007/s11418-021-01484-3.

21.Henschkowski J, Stuck AE, Frey BM, et al. Age-dependent decrease in 11beta-hydroxysteroid dehy-drogenase type 2 (11beta-HSD2) activity in hypertensive patients[J]. AM J Hyrertens, 2008, 21(6): 644-649. DOI: 10.1038/ajh.2008.152.

22.李肖玲, 孙黎, 沈金芳, 等. 异甘草酸镁注射液正常人体耐受性试验[J]. 中国药房, 2006, 17(4): 279-281. [Li XL, Sun L, Shen JF, et al. Investigation on tolerance of magnesium isoglycyrrhizinate injection in healthy volunteers[J]. China Pharmacy, 2006, 17(4): 279-281.] DOI: 10.3969/j.issn.1001-0408.2006.04.015.