贝伐珠单抗联合化疗引起肾脏相关不良反应的临床观察

目的 观察晚期结直肠癌患者应用贝伐珠单抗联合化疗后出现高血压及蛋白尿的发生率.方法 选取2012年1月至2016年12月我科收治的晚期结直肠癌患者64例,行贝伐珠单抗联合化疗.贝伐珠单抗用药:第1天予5 mg/kg静脉滴注30~90 min,以2周为1个周期;或第1天予7.5 mg/kg静脉滴注30~90 min,以3周为1个周期.应用贝伐珠单抗后定期监测血压,贝伐珠单抗每个周期给药前48 h内,行尿常规或24 h尿蛋白定量检查.结果 贝伐珠单抗联合化疗后患者高血压发生率为26.6%,其中3级高血压发生率为7.8%,4级高血压发生率为1.6%.贝伐珠单抗联合化疗后患者蛋白尿的发生率为10.9%,其中3级蛋白尿的发生率为3.1%,无肾病综合征发生.结论 贝伐珠单抗联合化疗不良反应发生率较低,安全性较好,使用该药过程中应定期监测及时处理发生的不良反应.

Clinical observation of the adverse reactions on kidney induced by bevacizumab combined with chemotherapy

Objective To observe the adverse effects of bevacizumab combined with chemotherapy on the incidence of hyper -tension and proteinuria in the patients with advanced colorectal cancer .Methods Sixty-four patients with advanced colorectal cancer , who received medical care in our department of the hospital from January 2012 to December 2016, were enrolled for the study .The pa-tients were treated with bevacizumab combined with chemotherapy .The treatment profiles of bevacizumab medication were: venous dropping at a dosage of 5 mg/kg for a duration of 30~90 minutes was administered the first day , with 2 weeks as a treatment cycle;or venous dropping at a dosage of 7.5 mg/kg for a duration of 30~90 minutes was given the first day , with 3 weeks as a treatment cycle . Following medication of bevacizumab , blood pressure was detected regularly .Forty-eight hours before each treatment cycle , urine rou-tines or 24 hour quantitative urine protein were detected .Results The incidence of hypertension for the patients treated with bevaci-zumab combined with chemotherapy was 26.6%, of which the incidence of grade 3 hypertension was 7.8%and that of grade 4 hyper-tension was 1.6%.After combined treatment of bevacizumab and chemotherapy , the incidence of proteinuria was 10.9%, of which the incidence of grade 3 proteinuria was 3.1%, but without the occurrence of nephrotic syndromes .Conclusion Adverse drug reactions in the combined use of bevacizumab and chemotherapy were relatively low , with good safety .Nevertheless , regular monitoring of hyperten-sion and proteinuria should be made for the sake of safety .