阿瑞匹坦治疗顺铂方案化疗引起的呕吐临床分析

目的 探讨阿瑞匹坦用于以顺铂为基础的化疗所致恶心呕吐的临床疗效.方法 选取中山大学附属汕头医院2014年12月1日至2016年12月1日采用含顺铂(80 mg/m2)化疗方案的肿瘤患者,使用格拉司琼和地塞米松常规止吐后仍有呕吐的患者61例,进一步止吐采用阿瑞匹坦和地塞米松的患者为阿瑞匹坦组,采用格拉司琼和地塞米松的患者为格拉司琼组,观察两组患者小于24 h、24~72 h、>72~144 h的完全有效率(CR).结果 阿瑞匹坦组与格拉司琼组的24 h内CR率分别为66.67% 和51.61%,差异无统计学意义(P=0.232);24~72 h CR率分别为80.00% 和54.84%,阿瑞匹坦组显著优于格拉司琼组(P=0.036).>72~144 h CR率分别为86.67% 和64.52%,阿瑞匹坦组优于格拉司琼组(P=0.045).两种止吐药物的不良反应发现便秘、腹泻、荨麻疹、疲乏、焦虑差异无统计学意义(P>0.05),阿瑞匹坦组总的不良反应发生率在23.33%,而格拉司琼组为25.81%,差异无统计学意义(P>0.05).结论 阿瑞匹坦联合地塞米松用于高致吐性化疗药物顺铂化疗所致恶心呕吐的疗效较好,耐受性良好.

Clinical analysis of aprepitant for treating vomiting caused by cis-platin regimen

Objective To investigate the clinical efficacy of aprepitant in the treatment of cisplatin based chemotherapy in-duced nausea and vomiting.Methods The tumor patients treated with cisplatin(80 mg/m2)chemotherapeutic regimen in Affiliated Shantou Hospital of Sun Yat-Sen University from December 1,2014 to December 1,2016 were selected,61 cases still had vomiting after using granisetron and dexamethasone for routinely stopping vomiting,the patients with aprepitant and dexamethasone for fur-ther stopping vomiting served as the aprepitant group,while the patients with granisetron and dexamethasone as the granisetron group.Then the complete response(CR)rates within 24,24-72,>72-144 h were observed in the two groups.Results The CR rates within 24 h in the aprepitant group and granisetron group were 66.67% and 51.61% respectively,the difference was not sta-tistically significant(P=0.232),which at 24-72 h were 80.00% and 54.84% respectively,the aprepitant group was significantly better than the granisetron group(P=0.036),which at >72-144 h were 86.67% and 64.52% respectively,the aprepitant group was better than the granisetron group(P=0.045).The comparison of adverse reactions between the two antiemetic drugs found that constipation,diarrhea,urticaria,fatigue and anxiety had no significant difference(P>0.05),the occurrence rate of total adverse reactions in the aprepitant group was 23.33%,which in the granisetron group was 25.81%,the difference between the two groups was not statistically significant(P>0.05).Conclusion Aprepitant combined with dexamethasone has better effect for treating hy-peremetic chemotherapy drug cisplatin chemotherapy caused nausea and vomiting with good tolerance.