某院酪氨酸激酶抑制剂联合应用的疗效及不良反应的比较分析  

Comparative analysis of efficacy and adverse reactions of tyrosine kinase inhibitors in combination in a hospital

作　　者：陈富钦 曾珊 何幸清 周捷[1] 刘庆[1] 刘韬[1] CHEN Fu-qin;ZENG Shan;HE Xing-qing(Pharmaceutical Department of Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心药学部/华南肿瘤学国家重点实验室/肿瘤医学协同创新中心,广州510060

出　　处：《中国处方药》2022年第10期10-14,共5页Journal of China Prescription Drug

摘　　要：目的分析酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKI)联合应用的疗效及不良反应,为临床合理联合使用酪氨酸激酶抑制剂治疗肺癌提供参考。方法收集某院2019年12月~2021年12月的处方,筛选联合应用酪氨酸激酶抑制剂的医嘱,记录单用TKI和联用不同TKI后患者的临床数据,采用配对t检验统计分析患者联合用药前后的疗效及不良反应。结果安罗替尼与奥希替尼联合用药前后肿瘤大小差异有统计学意义(P<0.05);安罗替尼与阿美替尼联合用药前后肿瘤大小差异有统计学意义(P<0.05);安罗替尼与阿法替尼联合用药前后肿瘤大小差异无统计学意义(P>0.05);安罗替尼与埃克替尼联合用药前后肿瘤大小差异有统计学意义(P<0.05);安罗替尼与吉非替尼联合用药前后肿瘤大小差异无统计学意义(P>0.05)。各组联合用药前后肿瘤标志物浓度差异均无统计学意义(P>0.05)。安罗替尼与奥希替尼联合用药前后血小板、白细胞计数差异均有统计学意义(P<0.05)。安罗替尼与埃克替尼联合用药前后载脂蛋白-B差异有统计学意义(P<0.05)。安罗替尼+阿美替尼、安罗替尼+阿法替尼与安罗替尼+吉非替尼组各不良反应指标变化差异均无统计学意义(P>0.05)。结论安罗替尼+奥希替尼、安罗替尼+阿美替尼以及安罗替尼+埃克替尼三组用于治疗非小细胞肺癌疗效良好,但联合应用可能会使血小板与白细胞数目减少;安罗替尼+埃克替尼联合应用可能会使患者高脂血症的发生率增加;安罗替尼+阿法替尼或安罗替尼+吉非替尼用于治疗非小细胞肺癌在本研究中未能表现显著疗效,两者的联合使用是否合理,尚需更多的临床研究进行分析验证。Objective To analyze the efficacy and adverse reactions of tyrosine kinase inhibitors(TKIs)in combination,so as to provide reference for clinical rational combination of TKIs in treatment of non-small cell lung cancer.Methods Collect the prescriptions of a hospital from December 2019 to December 2021,screening the medical advices of combined use of TKIs,record a TKI alone and combination of different TKI patients after clinical data,paired t test statistical analysis curative effect and adverse reaction of patients before and after the combination.Results The tumor size before and after the combination of anlotinib and osimertinib,the difference was statistically significant(P<0.05).The tumor size before and after the combination of anlotinib and almonertinib,the difference was statistically significant(P<0.05).The tumor size before and after the combination of anlotinib and afatinib,the difference was not statistically significant(P>0.05).The tumor size before and after the combination of anlotinib and icotinib,the difference was statistically significant(P<0.05).The tumor size before and after the combination of anlotinib and gefitinib,the difference was not statistically significant(P>0.05).There was no statistical significance in the concentration of tumor markers before and after combination therapy(P>0.05).There were significant differences in platelet and leukocyte counts before and after the combination of anlotinib and osimertinib(P<0.05).There was significant difference in apolipoprotein-B before and after the combination of anlotinib and icotinib(P<0.05).There was no statistical significance in the changes of adverse reaction indexes in anlotinib+almonertinib,anlotinib+afatinib and anlotinib+gefitinib groups(P>0.05).Conclusion Anlotinib+Osimertinib,Anlotinib+Almonertinib and Anlotinib+Icotinib three groups have good efficacy in the treatment of non-small cell lung cancer and can try to be promoted with reduce platelets and white blood cell counts.The combination of Anlotinib+Icotinib may increase the i

关 键 词：酪氨酸激酶抑制剂 安罗替尼 非小细胞肺癌 治疗效果 不良反应 

分 类 号：R734.2[医药卫生—肿瘤]