贝伐珠单抗不良反应的文献计量分析

发布时间：2019-01-26 09:13

【摘要】：目的:对贝伐珠单抗在临床应用的安全性进行评价,为其临床合理、安全使用提供参考。方法:利用文献计量分析的方法,以"贝伐单抗""贝伐珠单抗""安维汀""不良反应""Avastin""Bevacizumab""Adverse reaction"为关键词,检索Pub Med、Ovid、Web of Science、相关期刊论文、维普和万方数据库自建库起至2015年12月收录的文献。采用End Note X7软件对检索到的文献进行去重、分类,利用Excel 2007软件对纳入文献的发表时间、发表国家、适应证、药品不良反应(ADR)累及器官/系统及临床表现进行分析。结果:共纳入文献240篇,其中论著199篇、综述19篇、病例报道22篇。贝伐珠单抗用于恶性实体瘤时常见的ADR有高血压、出血、动脉/静脉血栓、蛋白尿等,与说明书相符;而说明书中记载的常见ADR腹泻、便秘未见相关报道;此外,心力衰竭可能是被忽略的严重的ADR。大剂量是发生高血压的高危因素;肿瘤部位和类型与出血的风险相关;高龄和血栓病史是发生血栓的高危因素。在超适应证用于眼部新生血管疾病时的ADR包括角膜擦伤、晶状体损伤、眼内炎、眼压升高、视网膜脱落和葡萄膜炎等。结论:临床医师、药师在选择贝伐珠单抗治疗相关疾病时应排除使用该药可能发生严重的ADR的高危人群,并对其常见的ADR进行合理监测,选择合适的剂量和疗程,发生ADR时要及时正确地处理。
[Abstract]:Objective: to evaluate the safety of bevacizumab in clinical application and to provide reference for its rational and safe use. Methods: by means of bibliometric analysis, the key words were "bevacizumab", "Avastin", "Bevacizumab" and "Adverse reaction", and the full text database of Pub Med,Ovid,Web of Science, Chinese periodicals was searched. WIP and Wanfang databases since the establishment of the database until December 2015 documents included. End Note X7 software was used to remove and classify the retrieved documents, and Excel 2007 software was used to analyze the time of publication, country of publication, indications, adverse drug reactions (ADR) involving organs / systems and clinical manifestations. Results: a total of 240 articles were included, including 199 articles, 19 reviews and 22 case reports. The common ADR used in malignant solid tumors were hypertension, hemorrhage, arterial / venous thrombosis, proteinuria and so on, which were in accordance with the instructions, but the common ADR diarrhea recorded in the instructions, constipation was not reported. In addition, heart failure may be a neglected severe ADR. High dose is a high risk factor for hypertension, tumor location and type are associated with the risk of bleeding, and old age and history of thrombus are high risk factors for thrombosis. ADR used for ocular neovascularization include corneal bruise, lens injury, endophthalmitis, elevated intraocular pressure, retinal detachment and uveitis. Conclusion: in selecting bevacizumab for treatment of related diseases, clinicians and pharmacists should exclude the high risk population for severe ADR, and monitor the common ADR reasonably, and select the appropriate dosage and course of treatment. ADR should be handled in time and correctly.
【作者单位】：四川省肿瘤医院药学部;
【分类号】：R96;G353.1

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