左旋门冬酰胺酶化疗方案致不良反应分析

目的 探讨左旋门冬酰胺酶化疗方案致不良反应发生的规律和特点,为临床合理用药提供参考。方法 检索1989年1月—2018年11月中国学术期刊（网络版）、万方数字化期刊全文库、中文科技期刊全文数据库（维普）、Pubmed中关于左旋门冬酰胺酶不良反应的不良反应个案报道,并进行回顾性分析。结果 共检索到56篇文献,82例病例。年龄集中在6～10岁。给药方式主要为静脉滴注。原患疾病主要以急性淋巴细胞白血病为主。不良反应大多发生于用药48 h内,构成比为45.1%。左旋门冬酰胺酶引发的不良反应主要涉及消化系统损害、皮肤及附件损害、血液系统损害和中枢神经系统损害,消化系统损害例数最多,临床表现主要为恶心呕吐、血浆淀粉酶升高、肝功能异常等。结论 临床应重视左旋门冬酰胺酶不良反应的危害性,加强药学监护,尽量避免或减少其所致不良反应的发生,确保患者用药安全。

Analysis of adverse reactions induced by L-asparaginase chemotherapy

Objective > To investigate the regularity and characteristics of adverse reactions induced by L-asparaginase, and to provide reference for clinical rational drug use. Methods Chinese Academic Journal (online), Wangfang Database, Chinese Science and Technology Journal Full-text Database (VIP), and PubMed databases were searched for adverse drug reactions induced by L-asparaginase chemotherapy from January 1989 to November 2018, and were made a retrospective analysis. Results A total of 56 articles were retrieved and 82 cases were retrieved. The age was concentrated between 6 and 10 years old. The mode of administration was mainly intravenous drip. The primary disease was mainly acute lymphoblastic leukemia. Most of the adverse reactions occurred within 48 h of administration, and the composition ratio was 45.1%. The adverse reactions caused by L-asparaginase mainly involved digestive system damage, skin and accessory damage, blood system damage, and central nervous system damage. The number of digestive system damage was the highest, and the clinical manifestations were mainly nausea and vomiting, elevated plasma amylase, and liver abnormal function, etc. Conclusion Clinical attention should be paid to the harmful effects of L-asparaginase adverse reactions, strengthen pharmaceutical care, try to avoid or reduce the occurrence of adverse reactions, and ensure the safety of patients.