摘要
目的分析伊立替康的主要不良反应及与迟发性腹泻的相关危险因素,提高伊立替康应用的安全性。方法借助医院合理用药监测系统(PASS系统),回顾性分析2009年1月至6月肿瘤科60例住院患者使用伊立替康单药或联合化疗患者的资料,对其进行不良反应及安全性分析。同时借助SPSS统计学软件,采用Crosstabs方法,分析患者不同临床和病理参数与不良反应的关系。结果伊立替康骨髓抑制发生率为75.00%,严重骨髓抑制(Ⅲ度以上)发生率为10.00%;迟发性腹泻发生率为40.00%,严重腹泻(Ⅲ度以上)发生率为10.00%;急性胆碱能综合征发生率为40.00%;恶心呕吐发生率为86.67%,重度恶心呕吐发生率(Ⅲ度以上)为8.33%。高龄是患者发生腹泻的危险因素。结论伊立替康的主要不良反应为骨髓抑制和胃肠道反应。因其迟发性腹泻与年龄相关,故对于老年特别是70岁以上患者应用伊立替康时应加强监护,必要时应调整剂量。口服碳酸氢钠和或庆大霉素等可能预防伊立替康的肠毒性。
Objective To retrospectively analyze the major adverse reactions and the relative risk factors of late-onset diarrhea for improving the application security of irinotecan.Methods With the help of hospital PASS system,the information of 60 cases using only irinotecan or combination chemotherapy from January to June 2009 in the oncology department of our hospital were collected and retrospectively analyzed on adverse reactions and safety.The Crosstabs method was adopted to study and analyze the relations between different kinds of patients′ clinical and pathological parameters with adverse reactions.Results The incidence of bone marrow suppression was 75.00%,severe bone marrow suppression（above Ⅲ degrees） incidence was 10.00%;delayed diarrhea incidence was 40.00%,severe diarrhea（above Ⅲ degrees） incidence was 10.00%;acute cholinergic syndrome incidence was 40.00%;the incidence of nausea and vomiting was 86.67%,the incidence of severe nausea and vomiting（above Ⅲ degrees） was 8.33%.The risk factor of tardive diarrhea was age.Conclusion The major adverse reactions of irinotecan are bone marrow suppression and gastrointestinal reactions.Delayed diarrhea caused by irinotecan is age-related.Using irinotecan in elderly patients,especially over the age of 70,intensive care should be strengthened,if necessary,dosage should be adjusted.Taking orally NaHCO3 or gentamycin may prevent intestinal toxicity of irinotecan.
出处
《中国药业》
CAS
2011年第3期41-42,共2页
China Pharmaceuticals
