聚乙二醇化重组人粒细胞刺激因子相关过敏反应临床特征及文献分析  

Clinical characteristics and literature analysis on pegylated recombinant human granulocyte colony stimulating factor associated anaphylaxis

作　　者：王舒桐 管秀雯 樊英 贺飞 Shutong WANG;Xiuwen GUAN;Ying FAN;Fei HE(Department of Pharmacy,National Cancer Center,National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Medicine,National Cancer Center,National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Pharmacy,The Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院药剂科,北京100021 [2]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [3]新疆医科大学附属中医医院药学部,乌鲁木齐830000

出　　处：《临床药物治疗杂志》2024年第10期43-48,共6页Clinical Medication Journal

摘　　要：目的了解聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)相关过敏反应的临床特点及处置方法。方法报道中国医学科学院北京协和医学院肿瘤医院收治的2例乳腺癌患者应用PEG-rhG-CSF后出现3级过敏反应的诊治经过,并对这2例患者及检索PubMed、Embase、中国知网、万方数据知识服务平台收集到的相关病例的主要临床资料进行描述性分析。结果纳入分析的患者共10例,男女比例3∶7,中位年龄52岁;原发疾病涉及7个癌种。10例患者中,7例应用PEG-rhG-CSF后出现过敏性休克;9例初次使用后过敏,该院1例第4次使用后过敏;2例在中止最初抗过敏治疗后数日内复发,该院2例使用抗组胺药和糖皮质激素治疗,可能是过敏性休克未复发的原因。结论使用前予糖皮质激素等预处理可降低PEG-rhG-CSF过敏反应严重程度。3~4级过敏性休克发生后,尽快给予肾上腺素抢救,地塞米松、苯海拉明抗过敏,辅以补液、吸氧、升压等对症治疗,患者预后良好。Objective To explore the clinical characteristics and treatment of anaphylaxis associated with pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF).Methods We reported the diagnosis and treatment of two breast cancer patients with grade 3 anaphylaxis after PEG-rhG-CSF treatment in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,and the other clinical cases collected from PubMed,Embase,CNKI,and Wanfang database.All of the cases were analyzed by descriptive statistical analysis.Results A total of 10 patients were included in the analysis,male to female ratio was 3∶7 at the median age of 52 years old.The primary disease involved 7 cancer species.Of the 10 patients,7 had anaphylactic shock,9 patients were allergic after initial use,and one patient at our hospital was allergic after the 4th use.2 cases recurred within a few days after discontinuation of the initial anti-allergic therapy,and 2 cases at our hospital were treated with antihistamines and corticosteroids,which may have prevented recurrence of anaphylactic shock.Conclusion Pretreatment with glucocorticoid before PEG-rhG-CSF can reduce the severity of adverse reactions.When an allergic reaction of 3 to 4 level occurs,epinephrine should be given as soon as possible.Other therapies should be given including dexamethasone and diphenhydramine for anti-allergy,supplemented by fluid rehydration,oxygen inhalation,hypertension and other symptomatic treatment to achieve good patient's prognosis.

关 键 词：聚乙二醇化重组人粒细胞刺激因子 过敏反应 药物相关不良反应 

分 类 号：R979.1[医药卫生—药品] R969.3[医药卫生—药学]