曲妥珠单抗致不良反应分析  

Clinical Analysis of Adverse Effects Induced by Trastuzumab

作　　者：刘小林[1,2] 符一岚[2] 朱秋燕[3] 王颖怡 童本定[1] 魏青[1] 

机构地区：[1]江苏省肿瘤医院药剂科,南京210009 [2]中南大学湘雅医学院附属肿瘤医院,长沙410013 [3]南通大学附属医院药学部,南通226001 [4]重庆市璧山区人民医院,重庆402760

出　　处：《药学与临床研究》2017年第1期63-66,共4页Pharmaceutical and Clinical Research

摘　　要：目的:探讨曲妥珠单抗(trastuzumab)致不良反应的特点,为临床合理用药提供参考。方法:选择本院乳腺内科应用曲妥珠单抗所致不良反应38例,又检索到中国期刊全文数据库、万方数据库、维普资讯网和Pub Med筛选出的曲妥珠单抗相关不良反应的文献10篇(39例),合并作为研究对象,针对患者的一般情况、合并化疗方案、不良反应出现时间及临床表现、治疗及转归进行分析。结果:我院38例患者中不良反应发生在给药后0~90 min者21例(55%),1~2 d者9例(24%),3~7 d者8例(21%);最常见不良反应为输液反应,严重不良反应为2例,表现为严重输液反应(过敏反应),永久终止曲妥珠单抗的治疗。在数据库检索到的39例中,不良反应发生在给药后0~90 min者30例(77%),大于7 d者4例(10%),未报道发生时间5例(13%);最常见不良反应为输液反应,严重不良反应为9例,包括非感染性肺炎和心脏毒性,未影响治疗。结论:曲妥珠单抗最常见的不良反应为输液反应,多在第一次输注时发生;用药前先给予苯海拉明、地塞米松预防,可降低其发生率;加强监测,预防心脏毒性,保证治疗的顺利进行。Objective： To learn the characteristics of adverse reactions induced by trastuzumab in order to provide references for rational use in clinical practice. Methods： A total of 38 patients with adverse effects induced by trastuzumab in our hospital and 39 patients in 10 articles about adverse effects induced by trastuzumab searched from China Journal Full-text Database（CJFD）, Wanfang database, VIP information network and Pub Med were recruited in this study. The general conditions of patients, combined chemotherapy, incidence time and clinical manifestations of adverse reactions, treatment and prognosis were analyzed.Results： Among the 38 patients in our hospital, adverse reactions occurred in 21 cases after drug administration at 0 to 90 min（55%）, 9 cases at 1-2 d（24%） and 8 cases at 3-7 d（21%）; the most common adverse reactions were transfusion reaction; there were two cases of serious adverse reactions with severe infusion reactions（anaphylaxis） and permanent termination of trastuzumab. In the 39 cases retrieved from database, adverse reactions occurred in 30 patients after drug administration at 0 to 90 min（77%）, 4 cases at more than 7 d（10%） and 5 cases at unknown time（13%）; the most common adverse reactions were transfusion reactions; there were 9 cases of serious adverse reactions, including non infection pneumonia and heart toxicity, which did not affect the treatment. Conclusion： The most common adverse reactions of trastuzumab are transfusion reactions, which often occurr at the first infusion, premedication of diphenhydramine and dexamethasone may reduce the incidence, and strengthening monitoring and prevention of cardiac toxicity may ensure smooth treatment.

关 键 词：曲妥珠单抗 不良反应 分析 

分 类 号：R969.3[医药卫生—药理学]