53例紫杉醇致过敏性休克的回顾性研究  

Retrospective Study on 53 Cases of Anaphylactic Shock Induced by Paclitaxel

作　　者：鲁萌[1] 王健[1] 戴建[1] 朱静静[1] 朱晓芳[1] LU Meng;WANG Jian;DAI Jian;ZHU Jingjing;ZHU Xiaofang(National Drug Clinical Trial Institution,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院国家药物临床试验机构,南京210008

出　　处：《中国药房》2018年第7期987-990,共4页China Pharmacy

基　　金：江苏省自然科学基金资助项目(No.BK20160108)

摘　　要：目的:为紫杉醇的临床安全用药提供参考。方法:检索2006-2016年中国医院数字图书馆中紫杉醇致过敏性休克的文献报道,筛选符合标准的文献后,对患者的性别与年龄分布、原患疾病、过敏性休克出现时间分布、预防用药情况、给药途径与剂量、联合化疗用药情况、前驱临床表现和抢救措施与转归等进行统计分析。结果:共纳入紫杉醇致过敏性休克病例53例,其中男性16例、女性37例,年龄17~72岁,以40岁以上女性患者所占比例(30例,56.60%)最高;原患疾病以肺癌(15例,28.30%)、乳腺癌(12例,22.64%)、卵巢癌(11例,20.75%)居多;过敏性休克主要发生在静脉滴注给药后的5 min内(34例,64.15%);45例(84.90%)患者使用紫杉醇前采用了抗过敏的预防用药方案;53例患者均为静脉滴注,单次给药剂量为30~300 mg;53例患者中,单独使用紫杉醇的有25例,其余患者均联用其他化疗药物;过敏性休克的前驱临床症状以心血管系统(123例次,36.07%)、皮肤及黏膜系统(73例次,21.41%)和呼吸系统(67例次,19.64%)表现为主;经抢救治疗后,报道的死亡病例2例(3.77%)。结论:临床用药时应重视预防紫杉醇致过敏性休克的发生。OBJECTIVE:To provide reference for safe drug use of paclitaxel in clinic.METHODS:The literatures about anaphylactic shock induced by paclitaxel were retrieved from China Hospital Knowledge Database during 2006-2016.After screening literatures which met inclusion criteria,the literatures were analyzed statistically in respects of the distribution of patient’s gender and age,primary disease,distribution of occurrence time of anaphylactic shock,prophylactic drug use,route of administration and dosage,combined with chemotherapy drugs,prodromal clinical manifestations,first-aid measures and prognosis,etc.RESULTS:A total of 53 cases of anaphylactic shock induced by paclitaxel were included,among which there were 16 male and 37 female,aged 17-72 years;female patients over 40 year-old took up the highest proportion(30 cases,56.60%).The major primary diseases were lung cancer(15 cases,28.30%),breast cancer(12 cases,22.64%)and ovarian cancer(11 cases,20.75%).Anaphylactic shock mainly occurred within 5 min after intravenous dripping(34 cases,64.15%).45 cases(84.90%)received antiallergic prophylactic program before using paclitaxel;53 patients were given intravenous dripping with single dose of 30-300 mg.Among 53 patients,25 patients were given paclitaxel alone,and other patients were given paclitaxel combined with chemotherapy drugs.The prodromal clinical symptoms of anaphylactic shock mainly involved cardiovascular system(123 case time,36.07%),skin and mucous membrane system(73 case time,21.41%)and respiratory system(67 case time,19.64%).2 patients(3.77%)died after rescue treatment.CONCLUSIONS:More attention must be paid to the occurrence of anaphylactic shock induced by paclitaxel.

关 键 词：紫杉醇 过敏性休克 回顾性研究 用药检测 用药安全 

分 类 号：R969.3[医药卫生—药理学]