仑卡奈单抗致阿尔茨海默病患者输液相关反应的临床观察与护理管理  

Clinical observation and nursing management of infusion-related reactions induced by lecanemab in Alzheimer disease patients

作　　者：范凯婷 乔雨晨[1] 王蕊[1] 谢冰心 Fan Kaiting;Qiao Yuchen;Wang Rui;Xie Bingxin(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《药物不良反应杂志》2024年第12期720-725,共6页Adverse Drug Reactions Journal

基　　金：中华医学会杂志社护理学科研究课题(CMAPH⁃NRI2022033)。

摘　　要：目的探讨仑卡奈单抗致输液相关反应(IRR)在我国阿尔茨海默病患者中的发生情况和临床特征,总结IRR的护理管理经验。方法本研究设计为单中心回顾性研究,研究对象为2024年6月26日至8月18日在首都医科大学宣武医院神经内科接受仑卡奈单抗(10 mg/kg,1次/2周)治疗的阿尔茨海默病患者。对患者使用仑卡奈单抗治疗期间IRR的发生情况、临床特征、严重程度及结局进行描述性分析。结果纳入研究的患者共45例,男性15例(33.3%),女性30例(66.7%);年龄为52~82岁,中位年龄62岁。45例患者中15例(33.3%)发生IRR,男性6例,女性9例,2例患者既往有过敏史;治疗周期数为1、2、3和4个者分别为3、8、1和3例。13例患者在仑卡奈单抗治疗前30 min给予苯海拉明预处理。14例患者的IRR发生在仑卡奈单抗治疗的第1周期,1例发生在第2周期。13例发生于仑卡奈单抗静脉滴注结束后5 h内,2例发生在用药后第2天。IRR的主要表现为发热、寒战,部分患者有头痛、恶心和呕吐症状,仅1例表现为皮疹和瘙痒。经对症处理后13例患者症状均很快缓解,继续按周期使用仑卡奈单抗,IRR未再次发生。IRR严重程度为1、2和3级者分别为5、9和1例,严重IRR的发生率为2.2%(1/45)。结论IRR为仑卡奈单抗的常见不良反应,主要表现为发热、寒战,症状较轻。一般为首次用药时发生,继续治疗不再发生。仑卡奈单抗用药时应常规监测生命体征,出现IRR时按严重程度及时处理,预后良好。Objective To explore the occurrence and clinical characteristics of infusion⁃related reactions(IRRs)caused by lecanemab in Chinese patients with Alzheimer disease,and summarize the nursing management experience of IRRs.Methods This study was a single center retrospective study and the subjects were Alzheimer′s disease patients who received lecanemab(10 mg/kg,once every 2 weeks)in the Department of Neurology,Xuanwu Hospital,Capital Medical University from June 26 to August 18,2024.The occurrence,clinical characteristics,severity,and outcome of IRRs that occurred during the treatment of lecanemab in these patients were descriptively analyzed.Results A total of 45 patients were included in the study,including 15 males(33.3%)and 30 females(66.7%);the age ranged from 52 to 82 years,with a median age of 62 years.Among the 45 patients,15(33.3%)developed IRRs,including 6 males and 9 females,and 2 of them had a previous history of allergy.In the 15 patients,there were 3,8,1 and 3 patients with 1,2,3 and 4 treatment cycles,respectively;13 patients were pretreated with diphenhyd-ramine 30 minutes before lecanemab treatment;14 patients had IRRs in the first cycle of lecanemab treatment,and 1 in the second cycle;IRRs occurred within 5 hours after finishing the intravenous infusion of lecanemab in 13 patients and on the second day after the administration in 2 patients.The main manifestations of IRRs were fever and chills;some patients had headache,nausea,and vomiting symptoms,and only 1 patient developed rash and itching.After symptomatic treatments,these symptoms in the 13 patients were relieved soon,and IRRs did not recur after the continued treatment of lecanemab according to the regime.The severity of IRRs was grade 1,2,and 3 in 5,9,and 1 patient,respectively.The incidence of severe IRRs was 2.2%(1/45).Conclusions IRRs are common adverse reactions of lecanemab,mainly characterized by fever and chills,with mild severity.Generally,lecanemab⁃related IRRs occurs after the first administra⁃tion,and may not occur again

关 键 词：阿尔茨海默病 仑卡奈单抗 输液相关反应 发热 

分 类 号：R473.74[医药卫生—护理学]