我院伊立替康用于晚期恶性肿瘤致不良反应56例分析

Analysis of 56 cases of ADR Induced by Irinotecan in Advanced Malignant Cancer Patients of Our Hospital

目的：探讨临床应用伊立替康致药品不良反应（ADR）发生的特点及规律,为临床合理用药提供参考。方法：采用回顾性研究方法,收集2011年6月-2015年1月我院应用伊立替康的56例晚期恶性肿瘤患者出现ADR的相关信息,按照性别、年龄、病种、美国东部肿瘤协作组（ECOG）评分、用药情况、ADR累及器官/系统、临床表现以及转归情况等进行描述性统计分析。结果：56例患者发生ADR累及器官/系统以骨髓造血系统所占比例最高（100%）,其次为消化系统;其中Ⅰ~Ⅱ级ADR占87.20%,Ⅲ~Ⅳ级ADR占12.80%。64.50%的ADR在用药1周内发生。ADR转归情况方面,85.71%（48/56）的患者给予支持治疗后恢复,继续后续周期化疗,其余8例给予药物减量并对症治疗后好转。结论：伊立替康采用规范化疗方案给药剂量,其临床耐受性良好,ADR多数表现轻微且对症处理均可恢复。应加强对患者随访,防止严重ADR的发生。

OBJECTIVE：To explore the characteristics and regularities of the adverse drug reactions（ADRs）induced by irinotecan,in order to provide reference for clinical application. METHODS：In retrospective study,56 cases of irinotecan-induced ADR collected from our hospital during Jun. 2011-Jan.2015 were analyzed statistically in respects of gender,age,disease types,ECOG score,medication,organs/systems involved in ADR,clinical manifestations,outcome,etc. RESULTS：All 56 patients suffered from ADR,among which the percentage of hematopoietic system accounted for the highest（100%）,and followed by digestive system;the grade Ⅰ-Ⅱ ADRs accounted for 87.20%,the grade Ⅲ-Ⅳ ADRs accounted for 12.80%. 64.50% of ADRs occurred within 1 week. In respect of conversion,85.71%（48/56）of the patients recovered with supportive care and continued chemotherapy,the remaining 8 cases had to reduce the dose of chemotherapy and then recovered. CONCLUSIONS：With regular dose,irinotecan is well tolerated. Since ADRs induced by irinotecan are slight,all the ADRs are well managed. It is important to enhance follow-up observations of patients to prevent some serious ADRs.