吉非替尼所致间质性肺病文献分析与对策探讨  

Analysis and Countermeasure of Interstitial Lung Disease Induced by Gefitinib

作　　者：金辉[1] 王陈翔[1] 周子晔[1] Jin Hui;Wang Chenxiang;Zhou Ziye(Department of Pharmacy,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院药学部,浙江温州325000

出　　处：《药物流行病学杂志》2020年第5期359-363,共5页Chinese Journal of Pharmacoepidemiology

基　　金：浙江省医药卫生科技计划项目(编号:2018KY519);浙江省自然科学基金项目(编号:LYY19H310007)。

摘　　要：目的:探讨吉非替尼致间质性肺病(ILD)的危险因素,为临床安全用药提供参考。方法:检索国内外吉非替尼引起的ILD报道文献共222篇,剔除资料缺失及重复报道的文献,对剩余文献中的患者一般资料、吉非替尼用药情况、实验室检查、ILD发生时间及相关症状、治疗和转归进行统计,采用单因素方差分析法分析吉非替尼致死的危险因素。结果:纳入分析文献52篇,涉及67例患者,其中男性38例,女性29例,年龄范围在28~85岁。ILD发生时间为用药后2~210d,2周内死亡的有11例。ILD的主要临床表现为呼吸困难、咳嗽、发热,伴典型的胸部CT改变。67例患者经相关治疗,好转46例,死亡21例。单因素方差分析显示性别、吸烟史、ILD出现时间和是否及时停药等4项因素可能成为ILD致死的危险因素。结论:吉非替尼致间质性肺病不良反应致死率高,需引起临床高度重视,早发现早治疗,采取正确的措施改善ILD患者的预后。Objective:To analyze the risk factors of interstitial lung disease(ILD)induced by gifitinib and provide reference for clinical safe medication therapy. Methods:A total of 222 domestic reports of ILD caused by gefitinib were retrieved. The data missing and repeated reports were excluded. The general information of patients, the use of gefitinib, the laboratory examination, the occurrence time of ILD and its related symptoms, treatment and outcome were analyzed on the remaining literature. Single factor analysis of variance was used to analyze the risk factors of death by gefitinib. Results:There were 52 articles included in the analysis, involving 67 patients, including 38 males and 29 females, with the age range of 28-85 years. The occurrence time of ILD was 2-210 days and 11 patients died within two weeks. The main clinical manifestations of ILD were dyspnea, cough and fever, with typical chest CT changes. 46 patients’ conditions were improved after correlation treatment but 21 patients died. Univariate analysis of variance showed that sex, smoking history, the occurrence time of ILD and whether to stop taking drugs in time might be the risk factors of death by ILD. Conclusion:The adverse drug reactions of ILD induced by gefitinib had a high mortality rate, which required important clinical attention. Correct measures should be taken like early detection and early treatment to improve the prognosis of ILD patients.

关 键 词：吉非替尼 间质性肺病 严重不良反应 文献综述 危险因素 

分 类 号：R979.1[医药卫生—药品]