672例抗肿瘤药物严重药品不良反应分析  

Severe Adverse Drug Reactions Induced by Anti-Tumor Drugs:A Report of 672 Cases

作　　者：江彦 黄爱文 JIANG Yan;HUANG Aiwen(Department of Clinical Pharmacy,No.900 Hospital of Joint Logistics Support Force of the PLA,Fuzhou,Fujian,China 350025)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院临床药学科,福建福州350025

出　　处：《中国药业》2022年第10期116-119,共4页China Pharmaceuticals

摘　　要：目的促进临床合理使用抗肿瘤药物。方法通过医院药品不良反应(ADR)监测管理系统提取某三甲医院2017年1月1日至2021年7月1日上报的抗肿瘤药物的严重药品不良反应(SADR)报告672份,参照国家药品不良反应监测中心分类评价方法,结合2020年版《中国国家处方集》和《WHO药品不良反应术语集》进行药品分类和主要临床表现定义,并分析其特点与转归。结果672例SADR中,女性明显多于男性(63.84%比36.16%),且多发生于中老年患者(41~70岁,80.36%);给药途径以静脉滴注为主(598例,88.89%);累及系统/器官以血液系统为主(500例,74.40%);涉及7大类抗肿瘤药物、51种药品,其中,最多见的药物类别是作用于DNA分子结构的药物(247例,36.76%),最多见的单药是多西他赛(143例,21.28%),最常见的临床表现为骨髓抑制。621例(92.41%)经对症治疗后缓解,其中痊愈39例(5.80%),好转582例(86.61%)。结论临床应加强对抗肿瘤药物ADR的主动监测以减少其发生,从而减轻患者的痛苦和经济负担,保障用药安全,并提高医院的医疗质量。Objective To promote the rational use of anti-tumor drugs in the clinic.Methods A total of 672 cases of severe adverse drug reactions(SADR)induced by anti-tumor drugs reported by a GradeⅢClass A hospital from January 1,2017 to July 1,2021 were extracted through the hospital adverse drug reaction(ADR)monitoring and management system.According to the classification and evaluation method of the National Center for ADR Monitoring,China's National Prescription Collection(2020 Edition)and WHO Adverse Drug Reactions Terminology,the drugs were classified and the main clinical manifestations were defined,and their characteristics and outcomes were analyzed.Results Among the 672 cases of SADR,the incidence of SADR in females was significantly higher than that in males(63.84%vs.36.16%),and mostly occurred in middle-aged and elderly patients(41-70 years old,80.36%).The main administration route inducing SADR was intravenous drip(598 cases,88.89%),and the main system/organ involved in SADR was blood system(500 cases,74.40%).Seven categories of anti-tumor drugs and 51 kinds of drugs were involved.Among them,the most common category was drugs that acted on DNA molecular structure(247 cases,36.76%),the most common single drug was docetaxel(143 cases,21.28%),and the most common clinical manifestation was bone marrow suppression.A total of 621 cases(92.41%)of patients were relieved after symptomatic treatment,of which 39 cases(5.80%)were cured and 582 cases(86.61%)were improved.Conclusion The active monitoring of ADR induced by anti-tumor drugs should be strengthened in the clinic to reduce its occurrence,so as to reduce the pain and economic burden of patients,ensure the safety of the medication,and improve the medical quality of the hospital.

关 键 词：抗肿瘤药物 严重药品不良反应 药品不良反应监测 药学监护 

分 类 号：R969.3[医药卫生—药理学] R979.1[医药卫生—药学]