贝伐珠单抗致不稳定型心绞痛1例及国内外不良反应报道分析  

Unstable angina induced by bevacizumab chemotherapy:Pooled analysis of 1 cases

作　　者：胡扬[1] 孙彬 李宁宁[3] 田庄[4] 冯雷[1] 梅丹[1] HU Yang SUN Bin LI Ning-ning TIAN Zhuang FENG Lei MEI Dan(Department of Pharmacy, Peking Union Medical College Hospital Beijing 100730, China Department of Pharmacy, Hulunbeier People＇s Hospital Mongolia, 021008, China Department of Cardiology, Peking Union Medical College Hospital Beijing 100730, China Department of Cardiology, Peking Union Medical College Hospital Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医院药剂科,北京100730 [2]呼伦贝尔市人民医院药学部,内蒙古021008 [3]中国医学科学院北京协和医院肿瘤内科,北京100730 [4]中国医学科学院北京协和医院心内科,北京100730

出　　处：《临床药物治疗杂志》2017年第3期46-48,共3页Clinical Medication Journal

基　　金：国家临床重点专科建设项目

摘　　要：目的:探讨贝伐珠单抗致心绞痛的临床特征、危险因素及诊治方案。方法:对1例应用贝伐珠单抗治疗结肠癌诱发不稳定型心绞痛的病例进行分析,并汇总分析国内外报道的不良反应文献。结果:本例54岁男性患者因结肠癌肝转移给予贝伐珠单抗300 mg+FOLFOX6(奥沙利铂+亚叶酸钙+氟尿嘧啶)静脉滴注,首次给药过程中出现胸痛急性发作,予硝酸异山梨酯片舌下含服后症状缓解,查心电图、心肌酶未见明显异常,患者停用贝伐珠单抗后未再出现胸痛。再次使用贝伐珠单抗后,胸痛再次发作,停用贝伐珠单抗,化疗方案为FOLFOX6,患者未再诉明显不适,予以出院。结论:贝伐珠单抗致心绞痛罕见,说明书未见贝伐珠单抗诱发心绞痛报道。本例属国内报道首例,国际报道第三例,值得关注和重视。医务人员在临床工作中,应注意贝伐珠单抗潜在心绞痛不良反应风险,尤其伴有冠心病危险因素的患者。若出现胸闷、胸痛等症状,应立即停药,给予对症治疗,最大限度降低药物性损害,避免延误病情,给患者造成不可挽救损失。Objective： To investigate the features of unstable angina induced by bevacizumab. Methods： Analysis was upon a case of unstable angina developed after administration of bevacizumab for the treatment of colon cancer. Results： The case of an 54-year-old man with colon cancer who developed chest pain during bevacizumab infusion is presented. Serial troponins and electrocardiograms（ECG） were unremarkable, and the chest pain was resolved after infusion of nitroglycerin. Repeated, the patient complained of recurring chest pain. This case supports the angina of bevacizumab cardiac toxicity. Conclusion： Cardiotoxicity associated with bevacizumab is an uncommon, but potentially lethal condition. We present the third case of acute angina due to bevacizumab-associated toxicity. The findings are discussed in light of the existing literature.

关 键 词：心绞痛 结肠癌 贝伐珠单抗 

分 类 号：R969[医药卫生—药理学]