四种5-羟色胺3受体拮抗剂防治化疗所致恶心呕吐的安全性

Safety Analysis of Four Kinds of 5-HT_(3) Receptor Antagonists in Preventing and Treating Nausea and Vomiting Caused by Chemotherapy

目的分析甲磺酸多拉司琼、昂丹司琼、托烷司琼和帕洛诺司琼防治化学治疗(化疗)所致恶心呕吐的安全性。方法收集2017年1月—2019年9月在河南省肿瘤医院、华中科技大学同济医学院附属同济医院、浙江大学医学院附属邵逸夫医院接受化疗的患者病历2417份,均使用过甲磺酸多拉司琼、昂丹司琼、托烷司琼、帕洛诺司琼预防或者治疗呕吐。排除合并心血管疾病及药物禁忌证患者。分析4种5-羟色胺3(5-HT 3)受体拮抗剂在组间或同组内分层间心血管不良事件和总不良事件的发生情况。结果该研究人群心血管相关不良事件总发生率为6.79%,多拉司琼组的心血管不良事件发生率显著低于托烷司琼组(P<0.05)。总不良事件发生率为59.12%,甲磺酸多拉司琼组总不良事件发生率显著低于其他组(P<0.05)。结论在防治化疗所致恶心呕吐方面,临床数据显示,对于无心血管疾病的肺癌、胃癌或乳腺癌患者,甲磺酸多拉司琼用药安全。但研究结论需进一步通过前瞻性研究验证。

Objective To investigate the safety of dolasetron,ondansetron,tropisetron,or palonosetron in preventing and treating nausea and vomiting caused by chemotherapy.Methods A total of 2417 patients who received dolasetron mesylate,ondansetron,tropisetron,and palonosetron to prevent or treat vomiting during therir chemotherapy treatment were retrospectively collected from Jan 2017 to Sep 2019 from Henan Cancer Hospital,Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine.Patients with cardiovascular diseases and four drug contraindications were excluded from the study.The occurrence of cardiovascular adverse events and the total adverse events among the four 5-hydroxytryptamine type 3(5HT 3)-receptor antagonists in different groups or within the same group were analyzed.Results The total incidence rate of cardiovascular-related adverse events in this study was 6.79%.The incidence rate of adverse cardiovascular events in the dolasetron group was lower than that in other groups,and it was significantly lower than that in the tropisetron group(P<0.05).The overall incidence rate of adverse events was 59.12%,and the total incidence of rate adverse events in dolasetron group was significantly lower than that in other groups(P<0.05).Conclusion Four groups of patients with lung cancer,stomach cancer,or breast cancer without cardiovascular disease,dolasetron mesylate was safe in preventing and treating nausea and vomiting caused by chemotherapy.The research conclusion needs further exploration and verification.