硫唑嘌呤致急性胰腺炎的文献分析  

Literature analysis of acute pancreatitis caused by azathioprine

作　　者：孙一琦 程晟[1] 廖音[1] 宋思洋 华梓欣 李纪千 李新刚 SUN Yiqi;CHENG Sheng;LIAO Yin;SONG Siyang;HUA Zixin;LI Jiqian;LI Xingang(Department of Pharmacy,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院药剂科,北京100050

出　　处：《临床药物治疗杂志》2025年第2期65-71,78,共8页Clinical Medication Journal

基　　金：北京市自然科学基金(Z230021);北京市属医院科研培育计划项目(PG2024002)。

摘　　要：目的探讨硫唑嘌呤致急性胰腺炎(AP)的临床特点及发生机制,为临床安全用药提供参考。方法检索中国知网、万方数据知识服务平台、维普资讯、PubMed、Web of Science数据库中有关硫唑嘌呤致AP的个案报道,检索时间自数据库建库至2024年11月7日。提取患者的基本信息、治疗方案、临床症状及转归等数据并进行整理与分析。结果纳入20篇文献涉及26例患者,其中11例为硫唑嘌呤单药引发的AP,2例可通过合并用药影响AP的发生,余13例虽排除合并用药影响但并不明确是否有促进作用。2例患者未报道转归,其余24例在治疗后病情均得到缓解或痊愈。6例患者再次使用硫唑嘌呤,均迅速出现了AP症状。结论硫唑嘌呤在治疗中引起AP的情况非常少见,建议在治疗早期密切监测患者是否出现AP相关症状,若怀疑患者可能发生AP时应尽快停药并进行对症治疗,避免再次使用。Objective To investigate the clinical characteristics and pathogenic mechanisms of azathioprine-induced acute pancreatitis(AP)and to provide a reference for the safe clinical use of the drug.Methods Case reports on azathioprineassociated AP were retrieved from databases including CNKI,Wanfang,VIP,PubMed,and Web of Science,with a search period spanning from the inception of these databases to November 7,2024.Data such as patient's demographics,treatment regimens,clinical symptoms,and outcomes were extracted,and data were systematically collated and analyzed.Results A total of 20 articles involving 26 patients were included.Among these,11 cases were attributed to AP induced by azathioprine monotherapy,2 cases could be attributed to the effects of combined drug use,and the remaining 13 cases had excluded the impact of combined medication,but it was not clear whether there was any potential promoting effect.Outcomes were not reported in 2 patients,while 24 patients achieved symptom alleviation or full recovery post-treatment.AP symptoms rapidly reoccurred in 6 patients who were re-exposed to azathioprine.Conclusion Azathioprine-induced AP is a rare adverse effect.Close monitoring for AP-related symptoms of patients during early treatment is recommended.If AP is suspected,prompt discontinuation of azathioprine and initiation of symptomatic treatment are critical.Rechallenge with azathioprine should be avoided.

关 键 词：硫唑嘌呤 急性胰腺炎 不良反应 病例分析 

分 类 号：R975[医药卫生—药品] R576[医药卫生—药学]