胺碘酮对非瓣膜性房颤复律后窦律维持患者肿瘤风险的相关性研究  

Relationship study between amiodarone and the risk of cancer in patients with sinus rhythm maintenance after cardioversion of non-valvular atrial fibrillation

作　　者：蓝晓红 杨艳 周永刚 许诺 邹颖[2] LAN Xiao-hong;YANG Yan;ZHOU Yong-gang;XU Nuo;ZOU Ying(General Hospital of Eastern Theater Command,Nanjing 210002,China;The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]东部战区总医院,江苏南京210002 [2]南京医科大学第一附属医院,江苏南京210029

出　　处：《中国药物应用与监测》2022年第1期8-12,共5页Chinese Journal of Drug Application and Monitoring

基　　金：江苏省药学会医院药学项目(Q2018043);南京药学会医院药学项目(2017YX010)。

摘　　要：目的:研究非瓣膜性房颤患者胺碘酮治疗与肿瘤风险的相关性。方法:对南京地区某三甲医院2001年1月–2010年12月998例非瓣膜性房颤患者胺碘酮治疗与肿瘤风险的相关性行队列研究。统计分析患者肿瘤风险的相关指标,采用单变量和多变量Cox比例风险模型分析胺碘酮cDDD值和肿瘤之间的关联性,确定接受胺碘酮治疗的患者发生肿瘤的预测因子,并考察低、中、高胺碘酮cDDD值患者肿瘤发病率的差异。结果:44例患者发展为恶性肿瘤,与正常人群相比肿瘤患病风险增加,但无统计学差异(P=0.058);男性患者接受胺碘酮治疗后肿瘤风险显著增加(P<0.05);合并肝硬化与肿瘤发生相关(P<0.001)。结论:胺碘酮治疗的非瓣膜性房颤患者肿瘤发生风险与性别、合并肝硬化和高剂量给药相关。临床药师应对胺碘酮治疗患者加强不良反应监测,对发生肿瘤的不良事件进行长期随访。Objective:To study the relationship between amiodarone and the risk of cancer in patients with non-valvular atrial fibrillation(AF).Methods:A total of 998 patients with non-valvular AF treated with amiodarone for maintaining sinus rhythm were collected from a third class hospital in Nanjing from January 2001 to December 2010,and then a cohort study was conducted in them.The relevant indicators of tumor risk in the enrolled patients were statistically analyzed in this study.And univariate and multivariate COX proportional hazard models were used to analyze the correlation between the cDDD value of amiodarone and tumor to determine the predictors of tumor.The difference of tumor incidence in patients with low,medium,and high amiodarone cDDDs was also analyzed.Results:44 patients developed malignant tumor,which indicated that the risk of cancer increased compared with the normal population,but there was no statistical difference(P=0.058).The tumor risk of male patients was significantly increased(P<0.05).The tumorigenesis was associated with liver cirrhosis(P<0.001).Conclusion:The risk of tumor in non-valvular AF patients treated with amiodarone was related to gender,liver cirrhosis and high dose administration.Clinical pharmacists should strengthen the monitoring of adverse reactions of patients treated with amiodarone and follow up the adverse events of tumor for a long time.

关 键 词：胺碘酮 肿瘤 非瓣膜性房颤 风险因素 

分 类 号：R969.4[医药卫生—药理学] R972[医药卫生—药学]