索拉非尼诱发高胆红素血症个案报道并肝功能障碍的文献统计分析  

Sorafenib-induced hyperbilirubinemia: one case report with a literature review

作　　者：白延宁 孙宝 张媛媛[3] 乔逸 杨志福 BAI Yan-ning;SUN Bao;ZHANG Yuan-yuan;QIAO Yi;YANG Zhi-fu(Department of Clinical Medicine,Affiliated Hospital,Yan'an University,Shanxi Yan'an 716000,China;Department of Pharmacy,First Affiliated Hospital,Xi'an Medical College,Shanxi Xi'an 710038,China;Department of Pharmacy,Second Affiliated Hospital,Shanxi University of Traditional Chinese Medicine,Shanxi Xianyang 712030,China;Department of Pharmacy,Xijing Hospital,Air Force Military Medical University,Shanxi Xi'an 710032,China)

机构地区：[1]延安大学附属医院临床药学科,陕西延安716000 [2]西安医学院第一附属医院药剂科,陕西西安710038 [3]陕西中医药大学第二附属医院药剂科,陕西咸阳712030 [4]空军军医大学西京医院药剂科,陕西西安710032

出　　处：《中国医院药学杂志》2021年第6期651-654,共4页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金(编号:81573549)。

摘　　要：目的:通过病例报告及文献分析探讨索拉非尼诱发的肝脏系统不良反应。方法:报告1例索拉非尼致患者胆红素升高的不良反应,检索国内外相关文献,汇总后进行文献统计分析。结果:包括本文报告的索拉非尼诱发胆红素升高的病例,共有16篇文献(17个病例)纳入研究。17个病例中男性15名,女性2名,患者年龄为47~77岁(平均年龄63岁)。接受索拉非尼治疗的患者中12例原发病为肝细胞,4例原发病为晚期肾细胞癌,1例原发病为甲状腺滤泡性腺癌。诱发的肝脏系统不良反应主要有肝功能异常(1例)、肝衰竭(3例)、肝损害(3例)、肝性脑病(5例)、高胆红素血症(2例)、急性肝炎(3例)。从开始接受索拉非尼治疗到诱发肝脏系统不良反应的持续时间为1~98 d(平均34 d)。不良反应结果中有2例患者结局未知,1例患者死亡,其余14例患者平均康复时间为15.1 d。结论:索拉非尼诱发患者肝功能障碍的文献报道很少,已报道病例的预后结果很差,建议临床医师应关注索拉非尼对肝脏的不良反应影响,在服用索拉非尼期间定期监测肝功能指标。OBJECTIVE To explore the adverse reactions of liver system induced by sorafenib through one case report and a literature review.METHODS One case of sorafenib-induced elevation of bilirubin was reported.The relevant domestic and foreign literatures were searched, collated and analyzed.RESULTS A total of 16 reports involving 17 cases of sorafenib-induced elevation of bilirubin were retrieved.There were 15 males and 2 females with a mean age of 63(47-77)years.The primary diseases were hepatocellular cancer(n=12),renal cell cancer(n=4)and thyroid follicular adenocarcinoma(n=1).The major hepatic adverse reactions were abnormal liver function(n=1),liver failure(n=3),liver damage(n=3),hepatic encephalopathy(n=5),hyperbilirubinemia(n=2)and acute hepatitis(n=3).The average duration from an initiation of sorafenib treatment to an induction of adverse reactions of liver dysfunction was 34(1-98)days.The outcomes were unknown(n=2)and death(n=1).The average recovery time of the remaining 14 patients was 15.1 days.CONCLUSION Few literature reports of sorafenib-induced liver dysfunction are available.And the prognosis is generally quite poor.While prescribing sorafenib, clinicians should pay close attention to adverse reactions of liver and regularly monitor the changes of liver function parameters.

关 键 词：索拉非尼 肝功异常 不良反应 

分 类 号：R979.1[医药卫生—药品]