抗肿瘤药物不良反应调查及临床合理用药评价

Investigation of Adverse Reactions of Anti-tumor Drugs and Evaluation of Clinical Rational Drug Use

目的:通过对100例使用抗肿瘤药物患者的临床不良反应发生情况进行统计分析,积累抗肿瘤药物临床用药经验,从而为更加合理的用药策略及风险预案提供参考与指导。方法:基于泰安市药品不良反应监测中心2019年1月—2020年1月的抗肿瘤药物监测数据,分析不良反应发生的性别及年龄分布、药物不良反应累及器官、抗肿瘤药物类别影响、外界影响因素等方面的临床特性。结果:共100例使用抗肿瘤药物患者,发生药物不良反应病例69例,不同性别药物不良反应发生率比较,差异无统计学意义(P>0.05);60~70岁药物不良反应发生率较高;累及皮肤、消化系统、肌肉系统、血液系统、神经系统、五官系统方面,其中在肌肉系统、神经系统和五官系统产生的药物不良反应占比较小,在消化系统及血液系统发生药物不良反应占比较大;细胞毒类药物不良反应占比较大,高达95%;抗肿瘤药物次数(>3次)、静脉注射药物、住院次数(>3次)均会影响药物不良反应发生率。结论:抗肿瘤药物不良反应的发生与药物本身的药理特性具有很大关系,同时患者机体耐受性也是主要影响因素之一。在临床用药前根据临床经验和患者实际制定合理的用药策略,准备风险预案是提高药物效力防止突发风险的有效方式。

Objective: To analyze the occurrence of clinical adverse reactions in patients with anti-tumor drugs, accumulate experience in clinical use of anti-tumor drugs, and provide reference and guidance for more rational drug use strategies and risk plans. Methods: Based on the monitoring data of antitumor drugs from January 2019 to January 2020 in Tai’an Adverse Drug Reaction Monitoring Center, the clinical characteristics of gender and age distribution of adverse reactions, organs involved in adverse drug reactions, types of antitumor drugs and external influencing factors were analyzed. Results: A total of 100 patients were treated with antineoplastic drugs, and 69 cases of adverse drug reactions occurred. There was no significant difference in the incidence of adverse drug reactions between different genders(P>0.05). The incidence of adverse drug reactions was high in 60-70 years old. Cumulative skin, digestive system, muscle system, blood system, nervous system, facial system, in which the adverse drug reactions in the muscle system, nervous system and facial system accounted for relatively small, in the digestive system and blood system adverse drug reactions accounted for relatively large;the adverse reactions of cytotoxic drugs accounted for a large proportion, up to 95%;the frequency of anti-tumor drugs(> 3 times), intravenous drugs, hospitalization(> 3 times) will affect the incidence of adverse drug reactions. Conclusion: The prevalence of adverse reactions of antitumor drugs is closely pertinent to the pharmacological properties of the drugs themselves, and the patient’s tolerance is also one of the main influencing factors. It is an effective way to improve drug efficacy and prevent sudden risk by making reasonable medication strategy and preparing risk plan based on clinical experience and actual condition of patients before clinical medication.