1例甲磺酸阿帕替尼致下消化道出血的病例分析

A Case Analysis of Lower Gastrointestinal Bleeding Induced by Apatinib Mesylate

目的报道1例甲磺酸阿帕替尼致下消化道出血的案例,并对出血原因进行分析,为临床合理使用甲磺酸阿帕替尼提供参考。方法结合本例罕见的不良反应报告,检索国内外相关文献,参考国家药品不良反应评价中心制定的不良反应关联性评价标准和诺氏评估量表法对不良反应进行分析评价,探讨甲磺酸阿帕替尼与出血的关联性。结果该例不良反应符合不良反应关联性评价标准中的"很可能",诺氏评估量表法评分为6分(分值5~8分为很可能有关)。结论甲磺酸阿帕替尼与出血的关联性评价结果为"很可能有关"。因此,临床中应重视甲磺酸阿帕替尼在治疗疾病过程中的双重作用,在考虑药物疗效的同时,其不良反应也不应忽视。

OBJECTIVE To report a case of lower gastrointestinal bleeding caused by apatinib mesylate, and analyze the causes of bleeding, so as to provide reference for clinical rational use of apatinib mesylate. METHODS Combined with the rare adverse reactions(ADR) report of this case, we searched the relevant literature at home and abroad, referred to the evaluation standard of adverse reaction association formulated by the national center for adverse drug reaction evaluation and the Naranjo, analyzed and evaluated the adverse reactions, and discussed the association between apatinib mesylate and bleeding. RESULTS The ADR in this case met the criteria of "probable" in the evaluation of ADR association, and the score of Naranjo was 6 points(the score of 5-8 points was probably related). CONCLUSION The correlation between apatinib mesylate and bleeding is "probably related".In clinical work, we should pay attention to the dual role of drug in the treatment of diseases.While considering the effect of drug treatment, its adverse reactions should not be ignored.