妊娠期暴露抗蠕虫药风险评估的相关研究进展  

Research progresses of risk assessment of exposure to anthelmintic drugs during pregnancy

作　　者：路文柯 秦博 周迷 沈浩 张子雨 何元媛 朱玉莲 杨勇 Lu Wenke;Qin Bo;Zhou Mi;Shen Hao;Zhang Ziyu;He Yuanyuan;Zhu Yulian;Yang Yong(School of Medicine,University of Electronic Science and Technology of China,Personalized Drug Therapy Key Laboratory of Sichuan Province,Chengdu 611731,China;Department of Pharmacy,Ziyang People’s Hospital,Sichuan Province,Ziyang 641300,China;Department of Pharmacy,Sichuan Academy of Medical Sciences,Sichuan Provincial People’s Hospital,Affiliated Hospital of University of Electronic Science and Technology of China,Personalized Drug Therapy Key Laboratory of Sichuan Province,Chengdu 610072,China)

机构地区：[1]电子科技大学医学院个体化药物治疗四川省重点实验室,成都611731 [2]四川省资阳市人民医院药学部,641300 [3]四川省医学科学院·四川省人民医院电子科技大学附属医院药学部个体化药物治疗四川省重点实验室,成都610072

出　　处：《中国医药》2021年第2期317-320,共4页China Medicine

基　　金：四川省卫生健康委员会科研课题(19PJ307)。

摘　　要：以Pub Med、Web of Science、EMbase、中国知网、维普中文期刊数据库(VIP)和万方数据库为数据源,计算机检索建库至2020年6月公开发表的有关抗蠕虫药物妊娠期暴露风险的研究,手工检索纳入文章中的重要参考文献作为补充,概述抗蠕虫药物与不良妊娠结局的相关性研究。分析表明,妊娠期暴露伊维菌素、甲苯咪唑和阿苯达唑与主要先天缺陷的增加之间没有相关性,但应在妊娠早期谨慎使用,特别是伊维菌素和甲苯咪唑。妊娠期使用甲苯咪唑可降低新生儿低出生体质量的风险,而妊娠中、晚期使用阿苯达唑对于新生儿体质量与存活率的影响研究意见不一致。总体认为,目前妊娠期暴露抗蠕虫药的风险相关研究较为局限,尚需建立抗蠕虫药的多中心妊娠登记系统,观察不良妊娠结局的流行率是否超过了最近未服用此类药物的对照人群,并同步进行动物毒理学研究,还需要更多设计良好的大规模随机对照试验来确定妊娠期抗蠕虫治疗的安全性。Pub Med,Web of Science,EMbase,China National Knowledge Internet,VIP Chinese Journal Database and Wanfang Data were used as data sources.The studies on the risk of exposure to anthelmintic drugs during pregnancy published until June 2020 were collected by searching strategies,and supplemented by manual retrieval of important references.The analysis showed that there was no correlation between exposure to ivermectin,mebendazole and albendazole during pregnancy and the increase of major congenital defects,but these drugs should be used cautiously in the early stage of pregnancy,especially ivermectin and mebendazole.The use of mebendazole during pregnancy can reduce the risk of low birth weight,while researches have different views on the influence of albendazole on neonatal weight and survival,when it is used in the second and third trimester.Generally speaking,the current research on the risk of exposure to antihelmintics during pregnancy is relatively limited,and a multicenter pregnancy registration system for antihelmintics needs to be established.Observe whether the prevalence of adverse pregnancy outcomes exceeds the control population who has not recently taken such drugs,and simultaneously conduct animal toxicology studies are needed.More well-designed large-scale randomized controlled trials are needed to determine the safety of anti-helminth therapy during pregnancy.

关 键 词：抗蠕虫药 妊娠 风险 

分 类 号：R287[医药卫生—中药学]