纳米白蛋白给药系统改善紫杉醇化疗不良反应效果及其临床调查

Investigation on the Improvement of Adverse Reactions of Paclitaxel by Nanoparticle Albumin-bound Paclitaxel and Its Clinical Status

目的 调查临床上纳米白蛋白结合型紫杉醇(nanoparticle albumin-bound paclitaxel,Nab-P)和传统溶剂型紫杉醇化疗相关不良反应的发生率、严重程度,分析纳米白蛋白给药系统改善化疗不良反应的效果。方法 采用医院信息系统回顾性调查2019年7月—2021年12月在江苏大学附属医院肿瘤科确诊并接受Nab-P化疗的肿瘤患者326例和接受紫杉醇化疗的患者303例,从医疗电子病历和护理记录单中分别提取Nab-P和紫杉醇化疗相关不良反应的信息以及护理措施,探讨纳米白蛋白给药系统改善化疗不良反应的效果及临床现状。结果 Nab-P和紫杉醇相关恶心、呕吐、过敏反应、骨髓抑制、肝损伤、感觉异常、静脉炎等不良反应的发生率及严重程度均存在显著的差异性(P<0.05)。Nab-P相关骨髓抑制发生率及严重程度高于紫杉醇,其他不良反应均低于紫杉醇。结论 除骨髓抑制外,Nab-P相关不良反应明显低于传统紫杉醇。因此,应用Nab-P化疗的患者,临床治疗时需更加关注骨髓抑制的发生情况。

OBJECTIVE To investigate the clinical incidence and severity of adverse reactions related to nano-albuminbound paclitaxel(Nab-P)and traditional solvent-based paclitaxel chemotherapy,and analyze the improvement of adverse reactions of paclitaxel treatment by nano-albumin delivery system.METHODS A hospital information system was used to retrospectively investigate 326 cancer patients received Nab-P chemotherapy and 303 paclitaxel chemotherapy patients who were diagnosed in the Department of Oncology of the Affiliated Hospital of Jiangnan University from July 2019 to December 2021.The information of the adverse reactions related to Nab-P and paclitaxel treatment was extracted from the electronic medical records and nursing record sheets,to explore the effect and clinical status of the nano albumin drug delivery system to improve the adverse reactions of chemotherapy.RESULTS Nab-P and paclitaxel-related adverse reactions such as nausea,vomiting,allergic reactions,myelosuppression,liver injury,paresthesias,phlebitis and others were significantly different in incidence and severity(P<0.05).The incidence and severity of Nab-P-related myelosuppression was higher than that of paclitaxel,while the incidence and severity of all other adverse reactions treated with Nab-P were lower.CONCLUSION Except for myelosuppression,Nab-P-related adverse reactions are significantly lower than traditional paclitaxel.Therefor,for patients undergoing Nab-P chemotherapy,more attention should be paid to the occurrence of myelosuppression.