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目的:调查桂哌齐特致血液系统不良反应的临床特征以预防其发生。方法:以cinepazide、adverse reaction、leucopenia、agranulocytosis、thrombocytopenia、桂哌齐特、不良反应、白细胞、粒细胞和血小板为检索词,检索PubMed(1948-2010)、EMBASE(1966-2010)、中国生物医学文献数据库(CBM)(1978-2010)、中国期刊全文数据库(CNKI)(1979-2010)、中文科技期刊数据库(VIP)(1989-2010)、万方数据资源系统(1989-2010)和北京市药品不良反应监测网络(2005.01-2010.05),收集桂哌齐特致血液系统不良反应的文献和病例,对患者的一般情况、用药情况、不良反应类型和发生时间、临床表现、治疗措施和转归等资料进行回顾性分析。结果:获得桂哌齐特致血液系统不良反应的临床研究和不良反应报道共14篇,纳入16例患者,其中男性8例,女性8例,平均年龄(73.0±11.9)岁。原发病为脑梗死者9例,脑出血3例,外周动脉疾病3例、椎-基底动脉供血不足1例。桂哌齐特用药剂量为160、240、320、600和1200mg/d者分别为2、2、8、1和3例。用药后≤5、6～10、11～15和>15d发生不良反应者分别为7、3、1和5例。不良反应的首发症状多为发热。16例患者中有10例发生白细胞减少,4例发生粒细胞缺乏,1例发生血小板减少,1例同时发生白细胞和血小板减少。15例患者经停药及对症治疗,14例好转,1例死亡。1例患者未停药。结论:桂哌齐特易导致白细胞、粒细胞及血小板减少。临床应用桂哌齐特时应严密监测血液系统不良反应。
Objective: To investigate the clinical characteristics of adverse reactions of cinepazide-induced hematological system to prevent its occurrence. METHODS: PubMed (1948-2010), EMBASE (1966-2010), Chinese biomedicine (TCM) were enrolled in the study with cinepazide, adverse reaction, leucopenia, agranulocytosis, thrombocytopenia, cinepazide, adverse reactions, leucocytes, granulocytes and platelets (1978-2010), Chinese Journal Full-text Database (CNKI) (1979-2010), Chinese Science and Technology Periodical Database (1989-2010), Wanfang Data Resource System (1989-2010) and Beijing Drug Adverse Reaction Monitoring Network (2005.01-2010.05), collecting the literature and cases of adverse reactions caused by cinepazide-induced hematological system, the general situation of patients, medication, adverse reaction type and timing of onset, clinical manifestations, treatment and outcome And other data for retrospective analysis. Results: A total of 14 clinical studies and adverse reactions were reported in the adverse reactions of cinepazide-induced hematologic malignancies. There were 16 patients, including 8 males and 8 females, with an average age of (73.0 ± 11.9) years. The primary disease was cerebral infarction in 9 cases, cerebral hemorrhage in 3 cases, peripheral artery disease in 3 cases, vertebrobasilar artery insufficiency in 1 case. Cinepazide at doses of 160, 240, 320, 600 and 1200 mg / d were 2, 2, 8, 1 and 3, respectively. After treatment ≤5,6 to 10,11 to 15 and> 15d adverse reactions were 7,3,1 and 5 cases. The first symptom of adverse reactions are fever. Ten of the 16 patients had leukopenia, four had agranulocytosis, one had thrombocytopenia, and one had leukopenia and thrombocytopenia. Fifteen patients were stopped and symptomatic treatment, 14 patients improved, 1 patient died. 1 patient did not stop. Conclusion: Cinepazide easily lead to white blood cells, granulocytes and thrombocytopenia. Clinical application of cinepazide should be closely monitored blood system adverse reactions.