甲磺酸阿帕替尼片引起间质性肺疾病致死亡  

Death from interstitial lung disease caused by apatinib mesylate tablets

作　　者：蔡雪莹[1] 曾惠清[1] 陈小蓉 陈享星 朱思虹 黄叶梅 Cai Xueying;Zeng Huiqing;Chen Xiaorong;Chen Xiangxing;Zhu Sihong;Huang Yemei(Department of Respiratory Medicine,Zhongshan Hospital Affiliated to Xiamen University,Xiamen Zhongshan Teaching Hospital,Fujian Medical University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院/福建医科大学厦门中山教学医院呼吸内科,361004

出　　处：《药物不良反应杂志》2019年第6期449-451,共3页Adverse Drug Reactions Journal

摘　　要：1例53岁女性各型驱动基因阴性晚期肺癌患者接受培美曲塞二钠+顺铂方案2个周期(21 d为1个周期)化疗无效后,给予甲磺酸阿帕替尼片(阿帕替尼)500 mg/d口服。22 d后因患者出现手足皮肤反应而将阿帕替尼减至250 mg/d维持治疗。治疗7个月后,患者肺部肿瘤病灶缩小,但出现气促,CT检查显示双肺间质纤维化。停用阿帕替尼并给予激素治疗,患者症状进行性加重。停药第32天,复查CT显示患者双肺间质纤维化加重,出现Ⅰ型呼吸衰竭,给予甲泼尼龙500 mg/d静脉滴注及吸氧等处置,病情仍恶化。停药第37天,患者死亡。A 53-year-old female patient with advanced lung cancer,who was negative for all types of driving genes,received apatinib mesylate tablets(apatinib)500 mg/d orally after 2 cycles of ineffective chemotherapy of pemetrexed disodium plus cisplatin(21 days as 1 cycle).After 22 days of medication,apatinib was reduced to 250 mg/d because of the hand-foot skin reactions.After 7 months of treatment with apatinib,the pulmonary neoplasms shrank,but the patient developed shortness of breath.CT examination showed bilateral pulmonary interstitial fibrosis.Apatinib was discontinued and hormone therapy was given.The patient′s symptoms were progressively aggravated.On day 32 of drug discontinuation,CT scan showed that the pulmonary interstitial fibrosis was aggravated and the patient developed typeⅠrespiratory failure.An IV infusion of methylprednisolone 500 mg/d and oxygen inhalation were given.However,the patient′s condition was still deteriorating.On day 37 of drug discontinuation,the patient died.

关 键 词：蛋白激酶抑制剂 阿帕替尼 肺腺癌 肺疾病 间质性 

分 类 号：R563[医药卫生—呼吸系统] R73[医药卫生—内科学]