奥布替尼致低纤维蛋白原血症  

Hypofibrinogenemia induced by orelabrutinib

作　　者：张丽娜[1] 方薇 李进峰[1] 高健[1] 王冰[1] Zhang Lina;Fang Wei;Li Jinfeng;Gao Jian;Wang Bing(Department of Pharmacy,Weihai Municipal Hospital,Shandong Province,WeiHai 264200,China)

机构地区：[1]威海市立医院药剂科,威海264200

出　　处：《药物不良反应杂志》2022年第9期492-494,共3页Adverse Drug Reactions Journal

基　　金：山东省医药卫生科技发展计划项目(202103050916);山东省老年医学学会2021年科技攻关项目(LKJGG2021W123)。

摘　　要：1例78岁女性患者因淋巴瘤复发给予奥布替尼100 mg口服、1次/d,用药第2天患者粪潜血呈弱阳性,3 d后纤维蛋白原0.61 g/L,经冷沉淀凝血因子和冰冻血浆静脉滴注治疗后,纤维蛋白原略有恢复,患者未按医嘱规律服用奥布替尼,纤维蛋白原恢复至1.71 g/L。再次给予规律奥布替尼治疗,纤维蛋白原降至0.74 g/L,并出现双下肢内侧皮肤多处不规则瘀斑及出血点。停用奥布替尼,给予2次冷沉淀凝血因子10 U静脉滴注后,患者纤维蛋白原恢复至2.17 g/L。再次给予奥布替尼治疗后,纤维蛋白原降至0.94 g/L,再次间断输注冷沉淀凝血因子治疗3次,患者纤维蛋白原恢复至3.82 g/L。考虑患者纤维蛋白原降低为奥布替尼所致。A 78-year-old female patient was treated with orelabrutinib 100-mg once daily orally due to recurrence of lymphoma.On the 2nd day of treatment,the patient′s fecal occult blood was weakly positive.Three days later,fibrinogen was 0.61-g/L.After intravenous infusion of cryoprecipitated coagulation factor and frozen plasma,the fibrinogen level rose slightly.The patient did not follow the doctor′s advice and took orelabrutinib irregularly,and her fibrinogen level recovered to 1.71-g/L.After further regular treatment with orelabrutinib,her fibrinogen decreased to 0.74-g/L and irregular skin ecchymosis and bleeding spots appeared in the inner side skin of both lower limbs.The fibrinogen in the patient returned to 2.17-g/L after temporary suspension of orelabrutinib and receiving 2 times of intravenous infusion of cold precipitated coagulation factor 10 U,then decreased to 0.94 g/L after reuse of orelabrutinib,and finally recovered to 3.82-g/L after 3 times of intermittent infusion of cold precipitated coagulation factor.It is considered that the hypofibrinogenemia in the patient was caused by orelabrutinib.

关 键 词：纤维蛋白原缺乏症 奥布替尼 

分 类 号：R969[医药卫生—药理学]