107例培门冬酶药品不良反应临床病例及文献分析

Clinical and Literature Analysis of 107 Cases of Adverse Drug Reactions Induced by Pegaspargase

目的了解培门冬酶致药品不良反应(ADR)的发生情况与临床特点,为临床安全用药提供参考。方法收集中国医学科学院血液病医院2013年7月至2019年3月使用培门冬酶出现ADR的病例,并检索中国知网(CNKI)、维普中文期刊全文数据库(VIP)、万方数据库及Pubmed数据库中关于培门冬酶致ADR的个例报道,将所有病例的患者性别、年龄、原患疾病、用药情况、ADR发生时间等进行汇总分析。结果经筛选后共纳入107例,包括我院临床病例30例及文献报道病例77例。其中,男性67例(62.62%),女性40例(37.38%),10岁以下儿童占比最大(51.40%)。ADR发生于用药后3分钟至44天,临床表现以胃肠系统损害、血液系统损害和心血管系统损害最多。结论临床医师和药师应重视培门冬酶ADR的发生特点,在应用培门冬酶时,严密监测患者临床症状及凝血功能、肝功能等相关指标,以尽量降低ADR对患者造成的损害。

Objective To analyze the occurrence and clinical characteristics of adverse drug reactions induced by pegaspargase, so as to provide reference for clinical safe medication. Methods ADR cases induced by pegaspargase in the Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences from July 2013 to March 2019 were collected. In addition, case reports of adverse drug reactions induced by pegaspargase were retrieved from the CNKI database, VIP database, Wanfang database and Pubmed database. Then patients information such as gender, age, original disease, medication and the occurrence of adverse reactions was summarized and analyzed. Results Totally 107 patients were retrieved, including 30 clinical cases in our hospital and 77 literature cases. Among them, 67(62.62%) were males and 40(37.38%) were females, and 55(51.40%) were children under 10 years old. Adverse reactions occurred in 3 minutes to 44 days after administration of pegaspargase. The main clinical manifestations were gastrointestinal damage, blood system damage and cardiovascular damage. Conclusion Clinicians and pharmacists should pay attention to the occurrence characteristics of adverse reactions of pegaspargase. When using chemotherapy regimens containing pegaspargase, it should be closely observed the clinical symptoms and monitored related indicators such as coagulation function and liver function, in order to minimize the adverse drug reactions damage caused by pegaspargase.