25例多西他赛致过敏性休克的文献分析

Literature analysis of anaphylactic shock induced by docetaxel in 25 cases

目的调查分析多西他赛致过敏性休克的发生特点与防治规律,为临床安全用药提供参考。方法检索Pub Med、Medline、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库和维普中文期刊全文数据库(VIP)中有关多西他赛致过敏性休克的个案病例,时间为1996年1月-2019年1月;对发生人群分布、合并用药情况及患者临床症状等进行统计学分析。结果获21篇个案病例,共25例患者,其中男7例、女18例,年龄在50~59岁发生过敏性休克占比最高(48.00%),其中男、4例、女、8例,诱导期主要集中于0~5 min内(占56%)。合并用药、多西他赛给药量(溶媒)及滴速与患者发生过敏性休克未见线性关系。药物与不良事件因果关系诺氏(Naranjo’s)评分:肯定有关7例(28.00%),很可能有关16例(64.00%)。结论多西他赛致过敏性休克宜发于化疗初期,多见于中老年患者,临床用药时宜对该类人群重点监护,且辅以长时随访,以免药源性损害。

Objective To analyze the characteristics and general patterns of anaphylactic shock by docetaxel and provide a reference for clinical use. Methods Search of Pubmed, Medline, CNKI, CBM, Wan Fang Data, and VIP databases of anaphylactic shock induced by docetaxel, from January 1996 to January 2019. Statistical analysis of population distribution, combined use of drugs and clinical symptoms of the patients was carried out. Results There were 21 cases reported in a total of 25 patients, among them 7 males and 18 females. The incidence of anaphylactic shock was the highest(48.00%) between 50 and 59 years of age, of which 4 were male and 8 were female. The induction period was mainly concentrated in 0-5 min, accounting for 56%. And there was no linear relationship between the combined medication, docetaxel dosage(solvent), drop rate and anaphylactic shock. Naranjo’s score of causal relationship between drugs and adverse events: positive in 7 cases(28.00%), most likely in 16 cases(64.00%). Conclusion The anaphylactic shock induced by docetaxel should occur in the early stage of chemotherapy, which is usually seen in middle-aged and elderly patients. The clinical use of docetaxel should be monitored in a timely manner, supplemented by long-term follow-up, so as to avoid drug-induced damage.