甲磺酸阿帕替尼片致心脏毒性反应  

Cardiotoxic reactions induced by apatinib mesylate tablets

作　　者：何素梅 江翊国 程文秀 奉林 孙晓鸣 He Sumei;Jiang Yiguo;Cheng Wenxiu;Feng Lin;Sun Xiaoming(Department of Pharmacy,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China;Department of Oncology,the Affiliated Suzhou Science&Technology Town Hospital of Nanjing Medical University,Suzhou 215153,China)

机构地区：[1]南京医科大学附属苏州科技城医院药学部,215153 [2]南京医科大学附属苏州科技城医院肿瘤内科,215153

出　　处：《药物不良反应杂志》2019年第6期467-468,共2页Adverse Drug Reactions Journal

摘　　要：1例59岁女性患者因神经内分泌肿瘤伴腹腔内转移应用甲磺酸阿帕替尼片(500 mg口服,1次/d)靶向治疗。用药第3天患者突然出现胸闷、气急,血压170/102 mmHg(1 mmHg=0.133 kPa),心率43次/min;心电图示窦性心动过缓,QT间期从治疗前412 ms延长至502 ms,N-末端脑钠肽前体(NT-proBNP)2945 ng/L。停用阿帕替尼,给予吸氧、降压、营养心肌等对症治疗,2 d后患者症状逐渐缓解,血压恢复正常,NT-proBNP下降至291 ng/L。症状消失后,患者再次服用阿帕替尼(125 mg、1次/d)。7 d后,患者再次出现头晕和血压升高,NT-proBNP 782 ng/L,停药并对症处理后好转。A 59-year-old female patient received targeted therapy with apatinib mesylate tablets(500 mg orally,once daily)for neuroendocrine tumor-derived intraperitoneal metastasis.On the 3rd day of treatment,the patient suddenly developed chest distress and shortness of breath,her blood pressure was 170/102 mmHg,and heart rate was 43 beats/min.The electrocardiogram showed sinus bradycardia and prolonged QT interval from 412 ms before treatment to 502 ms.Her N-terminal probrain natriuretic peptide(NT-proBNP)was 2945 ng/L.Apatinib was withdrawn and symptomatic treatments such as oxygen inhalation,antihypertension,and myocardial nutrition were given.Two days later,her symptoms gradually relieved,blood pressure returned to normal,and NT-proBNP decreased to 291 ng/L.After the symptoms disappeared,the patient took apatinib(125 mg once daily)again.Seven days later,dizziness and hypertension occurred again and her NT-proBNP was 782 ng/L.After apatinib withdrawal and symptomatic treatments,the patient′s symptoms improved.

关 键 词：抗肿瘤药 心脏毒性 长QT综合征 高血压 阿帕替尼 

分 类 号：R9[医药卫生—药学]