某院奥沙利铂过敏反应临床分析及防治

目的总结奥沙利铂发生过敏反应的规律及特点,探讨过敏反应的防治策略,为临床用药提供参考。方法我院2013年1月~2018年12月发生的49例奥沙利铂所致过敏反应病例,对患者的一般情况、用药情况、过敏反应发生情况进行分析。并查阅了已发表文献中报道的奥沙利铂所致过敏反应的病例。结果奥沙利铂过敏反应各年龄段均有发生,中位年龄为52岁,以男性多见,发生时间以30 min内多见,程度以Ⅰ-Ⅱ度多见,中位累计疗程为第5程,中位累积剂量为636 mg。文献检索发现奥沙利铂诱导的过敏反应31例。最常见症状是低血压,还包括2例独特的表现为高血压危象的病例。结论瘙痒可能是奥沙利铂过敏的早期症状,需密切监测多次使用奥沙利铂的患者;高血压危象可能是奥沙利铂过敏反应之一;再次给予奥沙利铂时降低给药速度,可降低过敏反应发生的概率及程度;对于无法通过降低给药速度来避免发生过敏反应的患者,改变治疗方案可能是更好选择;预处理可能是有效的预防措施;应注意区分输液反应、其他化疗药物引起的过敏反应。

Clinical Analysis and Countermeasures of Oxaliplatin-induced Allergic in Our Hospital

Objective To identify the patterns and characteristics of allergic reactions induced by oxaliplatin,and to explore prevention and treatment strategies in order to provide reference for clinical treatment.Methods The clinical data on forty-nine cases of allergic reactions induced by oxaliplatin was collected between January 2013 and December 2018.The general conditions of the patients,medication and the occurrence of allergic reactions were analyzed.Other cases of oxaliplatin-induced allergic reactions reported in literature were also reviewed.Results Allergic reactions induced by oxaliplatin can occur at any age and the median age was 52 years old.Males were more susceptible and the onset mostly occurred within 30 minutes.Most of the cases were of levelsⅠ-Ⅱ.The median cumulative course of treatment was five,while the median cumulative dose was 636 mg.Thirty-one cases of oxaliplatininduced allergic reactions were retrieved from literature.The most common symptom was hypotension,and there were even two unique cases of hypertensive crisis.Conclusion Hypertension crisis may be one of the oxaliplatin-induced allergic reactions that can be mitigated by reducing the rate of administration.In case of allergic reactions that cannot be avoided by reducing the rate of administration,changing the treatment regimen may be a better choice.Pretreatment may be an effective preventive measure.Allergic reactions caused by other chemotherapeutic drugs as well as infusion reactions should be distinguished from those induced by oxaliplatin.