妇科恶性肿瘤患者铂类抗肿瘤药物新的不良反应  

New adverse reactions to platinum-based anti-tumor drugs in gynecological cancer patients

作　　者：王静[1,3] 王凤蝶 黎丹 冯国纹 王丹青 陈力 WANG Jing;WANG Fengdie;LI Dan;FENG Guowen;WANG Danqing;CHEN Li(Department of Pharmacy/Evidence-based Pharmacy Center,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Department of Pharmacy,Sichuan Mianyang 404 Hospital,Mianyang 621000,China;Department of Pharmacy,Meishan Hospital of West China Hospital of Sicuan University,Meishan 620010,China;Department of Pharmacy,The First People’s Hospital of Bijie City,Bijie,551700,China;Department.of Pharmacy,Langzhong Peolple’s Hospital,Langzhong 637400,China)

机构地区：[1]四川大学华西第二医院药学部/循证药学中心,成都610041 [2]四川大学华西第二医院妇产科,成都610041 [3]绵阳四〇四医院药学部,绵阳621000 [4]四川大学华西医院眉山医院(眉山市人民医院)药学部,眉山620010 [5]毕节市第一人民医院药学部,毕节551700 [6]阆中市人民医院药学部,阆中637400

出　　处：《西南医科大学学报》2023年第3期233-236,共4页Journal of Southwest Medical University

基　　金：四川省科技厅重点研发项目(2020YFS0131,2016FZ0081);卫生健康发展促进项目(BJHA-CRP-068);新锐肿瘤支持治疗课题研究项目(cphcf-2022-109)。

摘　　要：目的总结四川大学华西第二医院3年妇科恶性肿瘤患者使用铂类抗肿瘤药物发生药品不良反应(adverse drug reaction,ADR)的病例情况,分析其新的ADR发生特点,以提高临床用药安全。方法收集四川大学华西第二医院2019年10月1日至2022年9月30日上报至国家药品不良反应监测系统中的铂类ADR报告,回顾性分析患者一般资料、使用药物种类、原患疾病等信息,计算相关ADR发生率和占比。结果近3年共上报134例铂类抗肿瘤药物的ADR,其中妇科恶性肿瘤患者125例,新的ADR报告数为51例(40.80%)。其中又以卵巢癌居多(58.82%);51~60岁年龄组发生ADR以及新的ADR例数最多,占比均大于40%;不同铂类抗肿瘤药物新的ADR占比在38%~50%之间,且关联性大部分为很可能相关(94.12%);该类药物新的ADR发生时间集中在24 h内(88.24%),主要累及器官或系统为过敏(全身反应)占72.55%,神经系统次之(35.29%)。结论妇科恶性肿瘤患者使用铂类抗肿瘤药物发生新的ADR概率较大,发生时间较为迅速,年龄集中在51~60岁,不同铂类药物新的ADR主要累及系统具有一定特点,临床药师及临床医护人员应注意识别、积极处理、及时上报和总结,为后续进一步提高临床用药安全提供参考。Objective To sort out the cases of adverse drug reactions(ADRs)in gynecological cancer patients in West China Second University Hospital of sichuan University using platinum-based anti-tumor drugs in our hospital over the past three years,and to analyze the characteristics of new ADRs,so as to promote clinical safety of drug use.Methods Platinum-based ADR reports submit⁃ted to National Center for ADR Monitoring system by West China Second University Hospital of Sichuan University from October 1,2019 to September 30,2022 were retrospectively collected.General information of patients,drug types used,primary diseases and other information were summarized,and the incidence and proportion of related ADRs were calculated.Results In the past three years,134 cases of platinum-based anti-tumor drug ADRs were reported in our hospital,among which 125 cases were gynecological cancer pa⁃tients with original disease,51 cases(40.80%)were reported as new ADRs,and ovarian cancer patients were the majority(58.82%).The number of ADR and new ADR cases in 51~60 years old group was the largest,accounting for more than 40%.The proportion of new ADRs of different platinum-based anti-tumor drugs was between 38%and 50%,and most of the correlations were very likely(94.12%).The occurrence time of new ADR of these drugs was concentrated within 24 h(88.24%),and the main organ or system in⁃volved was allergy(systemic reaction)(72.55%),followed by nervous system(35.29%).Conclusions Gynecological cancer patients who use platinum-based anti-tumor drugs are at high risk of new ADRs,which occur rapidly and are concentrated in the 51~60 age group.The different platinum-based drugs had certain characteristics in terms of the systems they affect.Clinical pharmacists and medical staff should be attentive to recognizing,actively treating,timely reporting,and summarizing ADRs to provide guidance for im⁃proving clinical drug safety in the future.

关 键 词：妇科恶性肿瘤 铂类抗肿瘤药物 药物不良反应 

分 类 号：R711[医药卫生—妇产科学]