唑来膦酸致低钙血症文献分析

Literature analysis of hypocalcemia induced by zoledronic acid

目的 探讨唑来膦酸致低钙血症的发生特点和规律,为临床防治和安全用药提供参考。方法 检索PubMed、中国知网、万方和维普等数据库从建库至2022年10月中涉及唑来膦酸致低钙血症的个案报告,对文献进行统计分析。结果 共纳入文献28篇,患者35例,其中男16例,女19例,平均年龄(57.75±19.02)岁;低钙血症发生时间从1~30 d不等,30例(90.91%)在2周内发生;16例(59.26%)患者25-羟基维生素D3水平降低,提示维生素D缺乏;27例经治疗2 d~5个月钙水平恢复正常。结论 唑来膦酸可导致严重持久的症状性低钙血症,要重点关注高风险人群,用药后监测电解质变化,警惕低钙血症发生。

Objective To investigate the characteristics and regularity of hypocalcemia induced by zoledronic acid, so as to provide references for clinical prevention, treatment and safe drug use. Methods The case reports related to hypocalcemia induced by zoledronic acid were retrieved from PubMed, CNKI, Wanfang, and VIP databases from the establishment of the database to October 2022, and the literatures were statistically analyzed. Results A total of 28 literatures were retrieved, including 35 patients. There were 16 males and 19 females, with an average age of(57.75 ± 19.02) years. The occurrence time of hypocalcemia ranged from 1 to 30 d,and 30 cases(90.91%) occurred within 2 weeks. The level of 25-OHD3 decreased in 16 cases(59.26%), suggesting vitamin D deficiency. Calcium levels of 27 patients returned to normal after 2 d to 5 months of treatment. Conclusion Zoledronic acid can cause persistent hypocalcemia with severe clinical symptoms. It is important to pay attention to high-risk groups before medication, and monitor electrolyte changes after medication to guard against hypocalcemia.