静滴5-氟尿嘧啶致不良反应分析

Analysis of Adverse Reactions Caused by Intravenous Infusion of 5-Fluorouracil

5-氟尿嘧啶不良反应可能会导致治疗终止,所以分析其不良反应的发生规律、特点及转归具有重要意义。收集上海交通大学附属医学院苏州九龙医院2015年1月至2017年1月静滴5-氟尿嘧啶病例182例,其中相关不良反应病例64例,总结不良反应症状,分析不良反应的发生率与年龄、用药疗程和剂量强度的相关性,并归纳产生不良反应患者转归情况。经过统计分析,静滴5-氟尿嘧啶的相关不良反应发生率为35.16%(64/182),其中血液系统不良反应的发生率为56.25%(36/64),胃肠道不良反应的发生率为50.00%(32/64),神经系统毒性的发生率为6.25%(4/64),过敏反应的发生率为3.13%(2/64),咳嗽反应的发生率为3.13%(2/64)。静滴5-氟尿嘧啶相关不良反应的发生与年龄、疗程、剂量强度具有相关性,有统计学意义(P<0.05)。静滴5-氟尿嘧啶所致的不良反应主要为血液系统和胃肠道不良反应,较少出现神经系统毒性、皮肤过敏和咳嗽等不良反应。大部分出现不良反应的患者经停药或治疗后转归良好,未对原发疾病造成影响。静滴5-氟尿嘧啶所致相关不良反应与患者的年龄、用药疗程和剂量强度有关,因此,临床医师需要根据患者的实际情况使用5-氟尿嘧啶,注意合并用药的情况。建议使用时及时监测5-氟尿嘧啶血药浓度,做到个体化给药,并且密切关注相关不良反应,及时采取相应措施,提高患者的用药安全性。

The adverse reactions of 5-fluorouracil may lead to termination of treatment,so it is important to analyze the occurrence,characteristics and outcomes of adverse reactions.We collected 182 cases from January 2015 to January 2017 in Suzhou Kowloon Hospital School of Medicine Shanghai Jiao Tong University,including 64 cases about adverse reaction.The adverse reactions were summarized,and the correlation between the incidence of adverse reactions,age,course of treatment and dose intensity was analyzed,and the prognosis of adverse reactions was summarized.Based on the statistical analysis,the incidence rate of adverse reaction was 35.16%（64/182）,hematological response occurred in 56.25%（36/64）,gastrointestinal response occurred in 50%（32/64）,nervous system toxicity occurred in 6.25%（4/64）,anaphylaxis occurred in 3.13%（2/64）,and cough occurred in 3.13%（2/64）.Through analysis of the data,the conclusion was drawn that the incidence of adverse reactions was correlated with age,course of treatment,dose and intensity,and had statistical significance（P 0.05）.The adverse reactions caused by intravenous infusion of 5-fluorouracil mainly include adverse reactions of the blood system and gastrointestinal tract,and less adverse reactions such as nervous system toxicity,skin allergy and cough.Most of the patients with adverse reactions had good prognosis after discontinuation or treatment,and had no influence on primary diseases.Adverse events are associated with age,course of treatment and dose intensity,so clinicians need to use 5-fluorouracil according to actual condition of patients,and take notice of the combined use of drugs.It is suggested that the plasma concentration of 5-fluorouracil should be monitored in time to achieve individualized administration,and close attention should be paid to the related adverse reactions,and measures should be taken on time to improve the safety of drug use.