312例吉西他滨的不良反应分析

Analysis of adverse reactions in 312 cases of gemcitabine

目的收集我院吉西他滨不良反应(ADR)的资料,分析其发生的特点和规律,为临床合理用药提供依据。方法从医院信息系统导出我院2008年9月至2018年9月期间使用吉西他滨化疗的患者病例,提取其相关的ADR报告,进行汇总和统计分析,统计采用SPSS 18.0进行。结果 750份病例中,吉西他滨相关的ADR有312份,其中女性患者ADR发生率较男性患者高(48.68%比36.77%);50~69岁年龄段的ADR发生率最高(44.14%);卡氏功能状态(KPS)评分越低的患者对化疗药物越敏感,越容易发生ADR;联合用药方案中,吉西他滨+紫杉醇类化疗方案的ADR发生率最高(61.54%);胸腺癌的ADR发生率最高(62.50%),其次为血液系统肿瘤和生殖系统肿瘤(分别为58.62%和57.14%);ADR累及器官/系统主要以血液系统毒性为主,常见的是骨髓抑制,其次为消化系统损害,主要表现为恶心呕吐。结论吉西他滨相关的ADR个体化差异大,并受多种因素的影响,应当根据个体情况使用化疗药物,提高临床安全合理用药。

Objective Based on the data of gemcitabine adverse reactions(ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided. Methods From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0. Results Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients(48.68% vs36.77%) and the highest incidence in the age group of 50-69 years(44.14%). The patients with lower status(KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR(61.54%) and the highest incidence of ADR in thymic carcinoma(62.50%),followed by hematological and reproductive system tumors(58.62% and 57.14%, respectively);ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit. Conclusion Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs.