舒尼替尼致软组织肉瘤患者异常子宫出血病例分析  

Analysis of abnormal uterine bleeding caused by sunitinib in patients with soft tissue sarcoma

作　　者：孟慧杰 席庆[2] 胡永芳 MENG Hui-jie;XI Qing;HU Yong-fang(Department of Clinical Pharmacy,Beijing Tsinghua Changgung Hospital/School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Pharmacy,Aviation General Hospital,Beijing 100012,China)

机构地区：[1]清华大学附属北京清华长庚医院/清华大学临床医学院临床药学科,北京102218 [2]航空总医院药剂科,北京100012

出　　处：《中国临床药理学杂志》2020年第11期1580-1582,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的分析舒尼替尼使用中出现子宫出血的严重药物不良反应的原因。方法 1例32岁女性因软组织肉瘤服用舒尼替尼,服药2周后出现异常子宫出血,停药后出血停止,因病情需要继续服药后出血重新出现。患者因肝转移瘤拟进行肝部分切除术,入院后临床药师通过用药重整分析可能影响凝血的药物,并给出用药调整建议,且查阅文献共同参与制定止血治疗方案,患者术前遵嘱停药,第11天出血停止,但患者自行重新服用舒尼替尼后再次出现子宫出血,第2次停药13 d后(术后第2天)出血停止。出院随访2个月,患者未服用舒尼替尼,未出现子宫出血。结果与结论患者服用舒尼替尼后出现异常子宫出血,停药后出血停止,重新用药后再次出现,提示该药临床应用可能导致异常子宫出血的药物不良反应。舒尼替尼致出血与抑制血管内皮生长因子影响组织修复和内皮细胞更新和抑制血小板功能相关。Objective To analyze the causes of adverse drug reactions of uterine bleeding caused by sunitinib.Methods One 32-year-old woman took sunitinib for soft tissue sarcoma.After taking sunitinib for 2 weeks,she had abnormal uterine bleeding.After stopping the drug,the bleeding stopped.The patient took the medicine again because of the disease,and bleeding reappeared.The patient came to our hospital for partial hepatectomy surgery.After admission,the clinical pharmacists analyzed the drugs that may affect the coagulation through medication reconciliation and given suggestions for medication adjustment,and consulted the literature to make the hemostasis treatment plan.The patients stopped the medication before the operation,and the bleeding stopped on the 11th day.However,after the patients took sunitinib again,uterine bleeding occurred again.The second time the bleeding stopped 13 days later(on the second day after operation).The patients were followed up for 2 months without taking sunitinib and uterine bleeding.Results and Conclusion The abnormal uterine bleeding stopped after the drug withdrawal and appeared again when reuse of sunitinib,suggesting that the clinical application of this drug may lead to adverse drug reactions of abnormal uterine bleeding.The bleeding might be related to the inhibition of vascular endothelial growth factor on tissue repair endothelial cell renewal and platelet function.

关 键 词：舒尼替尼 子宫出血 药物不良反应 

分 类 号：R979.1[医药卫生—药品]