利巴韦林注射液致骨髓抑制不良反应及文献阅读分析  

Adverse reactions of myelosuppression induced by ribavirin injection and literature review analysis

作　　者：何丽霞 梁培[3] 殷勤 陈文刚 He Lixia;Liang Pei;Yin Qin;Chen Wengang(Pharmacy Department,The Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241000,China;School of Pharmacy,Wannan Medical College,Wuhu,Anhui 241002,China;Nanjing Drum Tower Hospital,Nanjing Medical University,Nanjing,Jiangsu 210008,China)

机构地区：[1]皖南医学院第二附属医院药剂科,安徽芜湖241000 [2]皖南医学院药学院,安徽芜湖241002 [3]南京大学医学院附属鼓楼医院,江苏南京210083

出　　处：《齐齐哈尔医学院学报》2025年第2期135-140,共6页Journal of Qiqihar Medical University

基　　金：省级研究生专业学位教学案例库(2022zyxwjxalk170)。

摘　　要：目的探究利巴韦林注射液骨髓抑制不良反应的特点,为临床安全合理使用利巴韦林注射液提供参考。方法回顾分析2022年9月-2023年8月本院收治的两例患者治疗期间出现不同程度的全血细胞减少,参考国家药品不良反应评价标准,并结合Naranjo评分标准进行评分,筛选可能引起该患者出现骨髓抑制不良反应的药物。结果检索中英文文献,排除患者疾病因素影响和合并用药情况,患者1使用利巴韦林期间出现骨髓抑制Naranjo评为7分,患者2使用利巴韦林期间出现骨髓抑制Naranjo评分为6分,两例不良反应相关性评价均为“很可能”,判断引起患者骨髓抑制的药物很可能为利巴韦林注射液,予以停药和给与粒细胞集落刺激因子、输血对症处理后患者血细胞逐渐恢复,出院时两患者白细胞和血小板已恢复正常,但仍存在贫血。结论利巴韦林注射液在临床应用过程中要注意疗程和用量,特别是贫血患者应尽量避免长时间、大剂量使用。Objective To explore the characteristics of myelosuppression adverse reactions induced by ribavirin injection,and to provide reference for the safe and rational use of ribavirin injection in clinical practice.Methods Two patients admitted to our hospital had showed different degrees of pancytopenia during treatment from September 2022 to August 2023.With reference to the national adverse drug reaction evaluation standard and combined with the Naranjo scoring standard,to investigate the drugs that may cause adverse effects of myelosuppression in this patient.Results Literature in both Chinese and English was searched,the influence of disease factors and the combination of drugs were excluded.The Naranjo score of myelosuppression during the use of ribavirin in patient one was seven and Naranjo score of myelosuppression during the use of ribavirin in patient two was six,and the correlation evaluation of adverse reactions in both cases was“very likely”.So it was concluded that ribavirin injection was most likely to cause myelosuppression in the patient.After discontinuation of ribavirin injection and administration of granulocyte colony-stimulating factor,blood cells gradually recovered after symptomatic treatment.At the time of discharge,white blood cells and platelets had returned to normal,but anemia was still present.Conclusions During the clinical application of ribavirin injection,attention should be paid to the course of treatment and dosage,especially in anemia patients,long time and large dose should be avoided.

关 键 词：利巴韦林 全血细胞减少 骨髓抑制 药品不良反应 

分 类 号：R73[医药卫生—肿瘤]