中国药物警戒 ›› 2019, Vol. 16 ›› Issue (5): 285-288.

• 安全性评价与合理用药 • 上一篇    下一篇

硼替佐米治疗多发性骨髓瘤患者致肠梗阻不良反应的回顾性分析

苗文娟1, 田稷馨1, 廖应熙1, 于雅晴2, 王晓丹1, 严海泓1, 章萍1,*   

  1. 1 中国医学科学院血液病医院药剂科,天津 300020;
    2 广东药科大学生命科学与生物制药学院,广东 广州 510006
  • 收稿日期:2019-02-18 修回日期:2019-06-11 出版日期:2019-05-20 发布日期:2019-06-11
  • 通讯作者: 章萍,女,本科,主管药师,医院药学。E-mail：miaowenjuan@ihcams.ac.cn
  • 作者简介:苗文娟,女,博士,主管药师,临床药学。

Retrospective Analysis of Bortezomib-induced Intestinal Obstruction in Multiple Myeloma Patients

MIAO Wenjuan1, TIAN Jixin1, LIAO Yingxi1, YU Yaqing2, WANG Xiaodan1, YAN Haihong1, ZHANG Ping1,*   

  1. 1 Department of Pharmacy, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences, Tianjin 300020, China;
    2 School of Life Sciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangdong Guangzhou 510006, China
  • Received:2019-02-18 Revised:2019-06-11 Online:2019-05-20 Published:2019-06-11

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摘要： 目的 探讨多发性骨髓瘤患者应用硼替佐米治疗过程中并发肠梗阻的发生情况。方法 采用病例回顾性方法,分析2014年1月至2018年12月中国医学科学院血液病医院673例接受硼替佐米治疗的多发性骨髓瘤患者用药后并发肠梗阻的发生特点。结果 共有42例患者使用硼替佐米治疗后发生肠梗阻,不同性别和年龄段发生率差异无统计学意义（P >0.05）。所有病例均表现为不完全性肠梗阻,肠梗阻发生在使用硼替佐米的中位疗程数为第2（1~8）个。其中,21例（50%）患者在使用硼替佐米时联用5-羟色胺受体拮抗剂类止吐药。29例（69.05%）患者梗阻前并发感染,均联用广谱抗菌药物,15例（35.71%）联用三唑类抗真菌药。经内科保守治疗后,大多数患者（35例,83.33%）肠梗阻症状一周后可缓解。肠梗阻缓解后再次接受化疗的患者,7例调整化疗方案减少硼替佐米剂量,5例调整至不含硼替佐米的化疗方案。结论 多发性骨髓瘤患者在使用硼替佐米治疗时一旦发生肠梗阻,往往会影响化疗方案顺利进行。临床应加强用药教育,积极预防肠梗阻的发生,提高用药安全性。

关键词: 多发性骨髓瘤, 硼替佐米, 肠梗阻, 药品不良反应, 回顾性分析

Abstract: Objective To investigate the clinical characteristics of intestinal obstruction induced by bortezomib in multiple myeloma patients, so as to provide reference for clinical safe drug use. Methods A retrospective method was used to collect and analyze the incidence of intestinal obstruction in 673 patients with multiple myeloma who received bortezomib from January 2014 to December 2018 in the Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences. Results A total of 42 multiple myeloma patients suffered from intestinal obstruction after treatment with bortezomib. There were no significant differences in gender and age between MM patients who used bortezomib with intestinal obstruction and without intestinal obstruction during the same period (P>0.05).All cases showed partial intestinal obstruction. The median occurrence chemotherapy course was the second (1~8) course of treatment with bortezomib. Among them, 21 patients (50%) used serotonin receptor antagonist antiemetics when using bortezomib. Twenty-nine patients (69.05%) complicated with infection before intestinal obstruction, and all of them were given broad-spectrum antibacterial drugs. In addition, 15 (35.71%) of them were combined with triazole antifungal drugs. After conservative medical treatment, most patients (35 cases, 83.33%) had remission of intestinal obstruction symptoms after one week. After remission of intestinal obstruction, 7 patients were adjusted to chemotherapy reducing the dose of bortezomib, and 5 patients were adjusted to chemotherapy without bortezomib. Conclusion Once intestinal obstruction occurred in the treatment with bortezomib in multiple myeloma patients, it often prevented the progress of chemotherapy remedy. Therefore, it is necessary to strengthen drug education and actively prevent the occurrence of intestinal obstruction, so as to improve the safety of medication.

Key words: multiple myeloma, bortezomib, intestinal obstruction, adverse drug reaction, retrospective analysis

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