替比夫定致横纹肌溶解症不良反应的回顾与分析（英文）

发布时间：2018-11-15 18:50

【摘要】：为调查替比夫定致横纹肌溶解症不良反应的临床特征和相关因素,检索了国内外相关医学文献数据库,并筛选北京市药品不良反应监测网络收到的替比夫定不良反应报告中致横纹肌溶解症的报告。病例收集时间截止至2014年,分析患者的一般情况、用药情况和不良反应发生时间、临床表现、治疗措施和转归等资料。阅读226篇文献和41篇不良反应报告后,最终共纳入22个病例。纳入的病例均为男性患者,平均年龄(34.5±11.2)岁,原发疾病均为慢性乙型肝炎,替比夫定用药剂量均为600 mg/d。不良反应发生的时间存在差异,用药后5个月及以内、6 10个月、11 15个月和15个月以上发生不良反应者分别为1例(4.5%)、11例(50.0%)、7例(31.8%)和3例(13.6%)。不良反应的首发症状多为恶心、呕吐、心悸、下肢乏力水肿。患者经停药及对症治疗后,有12例好转,4例遗留有身体功能损害,2例结局不明,4例死亡。患者的年龄(P=0.61)、用药疗程(P=0.54)、肌酸激酶(P=0.07)的水平与死亡无统计学相关性。临床医师使用替比夫定时应监测患者临床表现,必要时检查血清肌酸激酶水平。出现不良反应后应及时停药并给予对症治疗。
[Abstract]:In order to investigate the clinical characteristics and related factors of adverse reactions induced by tibivudine in rhabdomyolysis, the relevant medical literature database was searched at home and abroad. The adverse drug reaction monitoring network in Beijing received reports of tebivudine adverse reactions resulting in rhabdomyolysis. Case collection time to 2014, analysis of the general situation of patients, drug use and adverse reactions occurred time, clinical manifestations, treatment measures and outcomes and other data. After reading 226 articles and 41 ADR reports, 22 cases were included. All the patients included were male patients with an average age of (34.5 卤11.2) years. The primary diseases were all chronic hepatitis B, and the dosage of tibivudine was 600 mg/d.. The adverse reactions occurred in 1 case (4.5%) and 11 cases (50.0%) respectively. 7 cases (31.8%) and 3 cases (13.6%). The initial symptoms of adverse reactions were nausea, vomiting, palpitations and edema of the lower extremities. After withdrawal and symptomatic treatment, 12 cases improved, 4 cases left with physical damage, 2 cases with unknown outcome and 4 cases died. There was no significant correlation between death and age (P0. 61), course of treatment (P0. 54), creatine kinase (P0. 07). Clinicians using tibiff should regularly monitor the patient's clinical manifestations and, if necessary, check serum creatine kinase levels. Stop drugs and give symptomatic treatment in time after adverse reaction.
【作者单位】：北京大学第三医院药剂科;Department
【基金】：Foundation of Peking University Third Hospital,China(Grant No.BYSY-SEEDFUND-Y86447-01)
【分类号】：R685.5

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