论文部分内容阅读
目的:分析贝伐珠单抗致器官穿孔的发生规律及特点,为安全用药提供参考。方法:以“贝伐珠单抗”、“穿孔”为中文关键词,以“bevacizumab”、“perforation”为英文关键词,检索中国学术期刊全文数据库、维普中文科技期刊数据库、万方数据库以及PubMed,收集贝伐珠单抗致器官穿孔个案报道文献进行分析,检索时间为2004年2月—2016年3月。结果:共检索到贝伐珠单抗致器官穿孔个案报道32篇,涉及41例患者,男23例,女18例,年龄≥65岁的老年患者11例,穿孔多发生于开始用药后15周内(28例,68.3%)。穿孔部位主要累及胃肠道(26例,63.4%)及鼻中隔(11例,26.8%)。患者原患疾病主要为转移性大肠癌(24例,58.5%),贝伐珠单抗联合FOLFOX化疗(贝伐珠单抗奥沙利铂+亚叶酸钙+5-氟尿嘧啶)9例,FOLFIRI(贝伐珠单抗+伊立替康+亚叶酸钙+5-氟尿嘧啶)6例。有21例患者记录贝伐珠单抗用药剂量,其中每次化疗给予10 mg·kg-1有13例。贝伐珠单抗致致器官穿孔的临床症状与穿孔部位有关,胃肠道穿孔的临床表现为主要为腹痛、恶心呕吐、发热等;鼻中隔穿孔临床表现主要鼻痛,流鼻涕,间歇性鼻出血。结论:贝伐珠单抗致器官穿孔可能与患者原患疾病、联合化疗用药、给药剂量有关,应加强贝伐珠单抗致器官穿孔监测,及时发现和处理器官穿孔。
OBJECTIVE: To analyze the regularity and characteristics of organ perforation caused by bevacizumab and to provide reference for safe drug use. Methods: Using “bevacizumab” and “perforation” as the Chinese keywords and “bevacizumab ” and “perforation” as the English keywords, we searched the full-text database of Chinese academic journals, Periodical database, Wanfang database and PubMed to collect reported cases of organ perforation caused by bevacizumab. The retrieval time was from February 2004 to March 2016. Results: A total of 32 cases of bevacizumab-induced organ perforation were reported, involving 41 patients, 23 males and 18 females, and 11 elderly patients aged ≥65 years. Perforation occurred in 15 weeks after the start of medication Internal (28 cases, 68.3%). Perforation mainly involved the gastrointestinal tract (26 cases, 63.4%) and nasal septum (11 cases, 26.8%). Patients with primary disease were mainly metastatic colorectal cancer (24 cases, 58.5%), bevacizumab combined with FOLFOX chemotherapy (bevacizumab oxaliplatin + leucovorin + 5-fluorouracil) in 9 cases, FOLFIRI Bevacizumab + irinotecan + leucovorin + 5-fluorouracil) in 6 cases. Twenty-one patients recorded doses of bevacizumab, 13 of which received 10 mg · kg-1 per chemotherapy. The clinical symptoms of bevacizumab-induced organ perforation are related to the perforation site. The clinical manifestations of gastrointestinal perforation are mainly abdominal pain, nausea and vomiting, fever, etc. The clinical manifestations of nasal septum perforation are mainly nasal pain, runny nose, intermittent epistaxis . Conclusion: The perforation of the bevacizumab-induced organ may be related to the patient’s original disease, combination chemotherapy and dosage. The perforation of bevacizumab-induced organ should be monitored to detect and treat organ perforation in time.