200例治疗胃癌药物致药品不良反应
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摘要
目的:探讨治疗胃癌药物致药品不良反应(adverse drug reaction,ADR)发生的规律及特点,为临床合理用药提供依据。方法:对2016—2017年仙桃市第一人民医院氟尿嘧啶、卡培他滨、表柔比星、顺铂、伊立替康和多西他赛等6种治疗胃癌常用化疗药致ADR 200例进行回顾性分析。结果:200例ADR中,氟尿嘧啶、伊立替康和多西他赛所致ADR病例数所占比例居前3位,分别为28.50%(57例)、24.00%(48例)和18.00%(36例);男性、女性患者所占比例相当;患者年龄主要集中于>40岁;发生ADR的药品剂型主要为注射剂;引发ADR的给药途径主要为口服、静脉滴注和静脉注射;ADR主要累及消化系统、血液系统,临床表现以恶心、呕吐、腹泻及骨髓抑制为主;ADR多发生于用药后30 min内。结论:氟尿嘧啶、卡培他滨、表柔比星、顺铂、伊立替康和多西他赛等6种治疗胃癌常用化疗药所致ADR主要发生于中老年人群,发生时间集中于用药后30 min内,主要累及消化系统和循环系统,临床上应根据其特点加强药学监护和干预。
OBJECTIVE: To probe into the occurrence characteristics and laws of adverse drug reactions(ADR) induced by gastric cancer drugs, so as to provide reference for the rational drug use in clinic. METHODS: Retrospective analysis was conducted on 200 cases of ADR induced by six commonly used chemotherapy drugs for gastric cancer as fluorouracil, capecitabine, epirubicin, cisplatin, irinotecan and docetaxel in Xiantao the First People's Hospital during 2016-2017. RESULTS: Among the 200 patients with ADR, the proportion of ADR cases caused by fluorouracil, irinotecan and docetaxel took the top 3 places, respectively 28.50%(57 cases), 24.00%(48 cases) and 18.00%(36 cases). Male and female patients accounted for a similar proportion; patients were mainly concentrated at >40 years old. The main dosage forms of ADR were injections. ADR was mainly induced by oral administration, intravenous drip and intravenous injection. ADR mainly involved the digestive system and hematological system. The clinical manifestations were focus on nausea, vomiting, diarrhea and myelosuppression. ADR mainly occurred within 30 minutes after administration. CONCLUSIONS: ADR induced by fluorouracil, capecitabine, epirubicin, cisplatin, irinotecan, docetaxel mainly occur in middle-aged and elderly people, and the time of occurrence is concentrated within 30 minutes after administration. ADR mainly involved the digestive system and circulatory system, clinical monitoring and intervention should be strengthened according to its characteristics.
OBJECTIVE: To probe into the occurrence characteristics and laws of adverse drug reactions(ADR) induced by gastric cancer drugs, so as to provide reference for the rational drug use in clinic. METHODS: Retrospective analysis was conducted on 200 cases of ADR induced by six commonly used chemotherapy drugs for gastric cancer as fluorouracil, capecitabine, epirubicin, cisplatin, irinotecan and docetaxel in Xiantao the First People's Hospital during 2016-2017. RESULTS: Among the 200 patients with ADR, the proportion of ADR cases caused by fluorouracil, irinotecan and docetaxel took the top 3 places, respectively 28.50%(57 cases), 24.00%(48 cases) and 18.00%(36 cases). Male and female patients accounted for a similar proportion; patients were mainly concentrated at >40 years old. The main dosage forms of ADR were injections. ADR was mainly induced by oral administration, intravenous drip and intravenous injection. ADR mainly involved the digestive system and hematological system. The clinical manifestations were focus on nausea, vomiting, diarrhea and myelosuppression. ADR mainly occurred within 30 minutes after administration. CONCLUSIONS: ADR induced by fluorouracil, capecitabine, epirubicin, cisplatin, irinotecan, docetaxel mainly occur in middle-aged and elderly people, and the time of occurrence is concentrated within 30 minutes after administration. ADR mainly involved the digestive system and circulatory system, clinical monitoring and intervention should be strengthened according to its characteristics.
引文
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[4] 朱晓东,赵晓莹,彭伟,等.表柔比星联合奥沙利铂和短期5-FU持续滴注的EOF5方案一线治疗晚期胃癌的疗效评估[J].中国癌症杂志,2014,24(8):615-621.
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[9] 王涛,赵磊,李榆,等.周剂量多西他赛联合顺铂与周剂量多西他赛联合奥沙利铂治疗晚期胃癌的临床研究[J].中国癌症杂志,2015,25(2):150-154.
[10] 李建旺,黄春珍,元建华,等.伊立替康联合顺铂对比伊立替康单药二线治疗晚期胃癌的临床研究[J].临床肿瘤学杂志,2016,21(6):540-544.
[11] 秦晓冰,李金运,于韬.ECF与DOF方案治疗晚期胃癌的临床疗效观察[J].重庆医学,2015,44(11):1512-1513,1521.
[12] 魏春岚,袁长蓉.肿瘤患者口服化疗药物的研究进展[J].中华现代护理杂志,2014,20(14):1613-1616.
[13] 郭佳栋,张雪梅,刘影,等.8种治疗胃癌常用抗肿瘤药物致不良反应病例报告分析[J].中国药房,2016,27(33):4627-4630.
[14] 郭佳栋,张雪梅,刘影,等.8种胃癌化疗药物与药品不良反应的聚类关系分析[J].中国药事,2017,31(5):584-590.
[15] 齐宝华,马武,张淑莲,等.肿瘤化疗药物应用中的不良反应及影响因素[J].中国医师杂志,2016,18(z1):52-54.
[2] Nakamura A,Nakajima G,Okuyama R,et al.Enhancement of 5-fluorouracil-induced cytotoxicity by leucovorin in 5-fluorouracil-resistant gastric cancer cells with upregulated expression of thymi-dylate synthase[J].Gastric Cancer,2014,17(1):188-195.
[3] 王树滨,吴煊,陈晓秋,等.卡培他滨和替吉奥作为晚期胃癌一线诱导化疗后维持治疗的临床观察[J].中国肿瘤临床,2016,43(20):913-917.
[4] 朱晓东,赵晓莹,彭伟,等.表柔比星联合奥沙利铂和短期5-FU持续滴注的EOF5方案一线治疗晚期胃癌的疗效评估[J].中国癌症杂志,2014,24(8):615-621.
[5] 焦海波.肿瘤化疗药物的不良反应分析[J].当代医学,2014,20(7):46.
[6] 苏海刚.肿瘤化疗药物应用中的不良反应及影响因素[J].中国现代药物应用,2017,11(9):108-109.
[7] Lee SJ,Sohn TS,Lee J,et al.Adjuvant chemoradiation with 5-fluorouracil/leucovorin versus S-1 in gastric cancer patients follo-wing D2 lymph node dissection surgery:a feasibility study[J].Anticancer Res,2014,34(11):6585-6591.
[8] Yao Z,Guo H,Yuan Y,et al.Retrospective analysis of docetaxel,oxaliplatin plus fluorouracil compared with epirubicin,cisplatin and fluorouracil as first-line therapy for advanced gastric cancer[J].J Chemother,2014,26(2):117-121.
[9] 王涛,赵磊,李榆,等.周剂量多西他赛联合顺铂与周剂量多西他赛联合奥沙利铂治疗晚期胃癌的临床研究[J].中国癌症杂志,2015,25(2):150-154.
[10] 李建旺,黄春珍,元建华,等.伊立替康联合顺铂对比伊立替康单药二线治疗晚期胃癌的临床研究[J].临床肿瘤学杂志,2016,21(6):540-544.
[11] 秦晓冰,李金运,于韬.ECF与DOF方案治疗晚期胃癌的临床疗效观察[J].重庆医学,2015,44(11):1512-1513,1521.
[12] 魏春岚,袁长蓉.肿瘤患者口服化疗药物的研究进展[J].中华现代护理杂志,2014,20(14):1613-1616.
[13] 郭佳栋,张雪梅,刘影,等.8种治疗胃癌常用抗肿瘤药物致不良反应病例报告分析[J].中国药房,2016,27(33):4627-4630.
[14] 郭佳栋,张雪梅,刘影,等.8种胃癌化疗药物与药品不良反应的聚类关系分析[J].中国药事,2017,31(5):584-590.
[15] 齐宝华,马武,张淑莲,等.肿瘤化疗药物应用中的不良反应及影响因素[J].中国医师杂志,2016,18(z1):52-54.