多西他赛和紫杉醇致严重不良反应对比分析

目的：分析多西他赛和紫杉醇致严重不良反应的特点，为临床安全用药提供参考。方法收集2004年1月至2013年1月我省药品不良反应监测中心收到的多西他赛和紫杉醇引起的严重不良反应报告，比较2种药物所致严重不良反应临床表现及转归。结果共收集多西他赛和紫杉醇严重不良反应报告31份，涉及患者31例，不良反应33例次。31例患者中男性9例，女性22例；年龄31～76岁，平均年龄53岁。紫杉醇引起的严重不良反应17例次，主要临床表现为过敏性休克（70.59%）、过敏样反应（11.76%）、白细胞减少（11.76%）、骨髓抑制（5.88%）；多西他赛引起的严重不良反应16例次，主要临床表现为过敏样反应（31.25%）、骨髓抑制（18.75%）、白细胞减少（18.75%）、腹泻（6.25%）、过敏性休克（6.25%）、胃肠道出血（6.25%）、背痛（6.25%）、胸闷（6.25%）。停药及对症治疗后均好转或痊愈。结论多西他赛与紫衫醇致严重不良反应临床表现有所不同，与多西他赛相比，紫衫醇过敏性休克所占比例较高，使用时更应加强用药指导和监测。

Comparative Analysis of Serious Adverse Reactions Caused by Docetaxel and Paclitaxel

Objective To investigate the characteristics of serious adverse reactions caused by docetaxel and paclitaxel in order to provide reference for safe drug use in clinical practice. Methods Reports of serious adverse reactions were selected from reports caused by docetaxel and paclitaxel from Liaoning Adverse Drug Reaction Monitoring Center from January 2004 to January 2013. The clinical manifestations of serious adverse reactions and outcomes between the two drugs were compared. Results A total of 31 reports were entered, involving 31 patients and 33 cases of adverse reactions. Thirty one patients comprised 9 male and 22 female with average age of 53 years（31~76 years）. Seventeen cases of serious adverse reactions caused by paclitaxel included anaphylactic shock（70.59%）, anaphylaxis（11.76%）, leucopenia （11.76%） and marrow depression （5.88%）. Sixteen cases of serious adverse reactions caused by docetaxel included anaphylaxis（31.25%）, marrow depression（18.75%）, leucopenia（18.75%）, diarrhea（6.25%）, anaphylactic shock （6.25%）, gastrointestinal bleeding （6.25%）, back pain （6.25%） and dyspnea （6.25%）. After drugs were stopped and symptomatic treatments were given, all the patients were cured. Conclusion Docetaxel and paclitaxel have some different clinical manifestations in serious anaphylaxis, the ratio of anaphylactic shock caused by paclitaxel was highter than by docetaxel, so guidance of medication and monitoring should be strengthened.