结直肠癌患者发生奥沙利铂过敏反应的临床特点分析  

Clinical Analysis of Hypersensitivity Reactions to Oxaliplatin in Patients with Colorectal Cancer

作　　者：朱秋燕[1] 王颖怡 刘小林[3] 罗佳 符一岚 

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

出　　处：《肿瘤药学》2017年第4期509-512,共4页Anti-Tumor Pharmacy

摘　　要：目的分析结直肠癌患者应用奥沙利铂后出现过敏反应的临床特点和危险因素。方法收集320例采用奥沙利铂化疗的结直肠癌患者的临床资料,统计其过敏发生率,并分析其过敏反应的临床特征及危险因素。结果奥沙利铂的过敏反应发生率为6.56%(21/320),发生过敏的患者和无过敏的患者在性别、年龄、肿瘤部位和奥沙利铂生产厂家方面无显著差异。21例过敏患者中,Ⅰ、Ⅱ度过敏反应占80.9%(17/21),临床表现主要为皮肤反应、呼吸和消化系统症状。过敏反应发生的中位周期数为8,中位累积剂量为625.7 mg·m^(-2)。21例过敏患者对症处理后均好转,其中8例下一疗程继续使用奥沙利铂,6例(75%)再次发生过敏反应。结论奥沙利铂过敏反应以Ⅰ、Ⅱ度为主,临床表现主要为皮肤反应、呼吸和消化系统症状,也可见血压升高。过敏患者再次使用奥沙利铂的过敏发生率明显提高。Objective This study aimed to evaluate the clinical features and risk factors of hypersensitivity reaction to oxaliplatin in pa- tients with colorectal cancer. Methods Clinical data of 320 colorectal cancer patients treated with oxaliplatin were collected. The prevalence and risk factors for oxaliplatin-induced hypersensitivity reactions were observed and analyzed. Results The prevalence of hypersensitivity reactions to oxaliplatin was 6.56% （21/320）. No increased risk was associated with gender, age, tumor site and manufacturers of oxalipla- tin. Grade I and II hypersensitivity reactions occurred in 80.9% （17/21） of allergic patients. The most common manifestations included cutaneous reaction, respiratory and digestive symptoms. The median cycle of the first time of hypersensitivity reaction was 8. The median cumulative dose of oxalipatin was 625.7 mg·m^-2. The symptoms associated with anaphylaxis were relieved in the 21 cases after withdrawal of oxaliplatin infusion and treatment with antiallergic drugs. But after reintroduction of oxaliplatin in 8 patients, anaphylaxis recurred in 6（75%） patients. Conclusion Most of oxaliplatin-induced hypersensitivity reactions were grade I and II events with cutaneous reaction, respira- tory and digestive symptoms. Hypertension was also observed. Patients who experienced hypersensitivity reaction to oxaliplatin were more likely to develop allergic reactions when treated with oxaliplatin again.

关 键 词：奥沙利铂 过敏反应 结直肠肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]