目的 对文献报道的以及我院发现的卡培他滨导致严重高甘油三酯血症(hypertriglyceridemia,HTG)的案例进行分析,了解卡培他滨这一不良反应的发生特点及防范和干预措施。方法 在中国知网(CNKI)数据库和美国国家医学图书馆PubMed网站数据库检索卡培他滨导致严重HTG的案例报道,提取案例中患者的基本信息、卡培他滨用药情况、血甘油三酯(triglyceride,TG)水平、基础疾病、并发症以及降脂治疗情况等信息,应用Excel 2013对数据进行统计分析。结果 共有14篇文献详细报道了21例卡培他滨导致严重HTG(TG≥500 mg·dL-1)的病例。将文献报道的21例和我院发现的2例,共23例纳入分析。其中,男性10例,女性13例;平均年龄(57.6±8.8)岁;18例患者的TG水平为4级,5例为3级;12例患者既往有血脂异常、血糖异常或肥胖等基础疾病;13例患者在发生高脂血症时的同时并发高胆固醇血症、高血糖或急性胰腺炎等;16例患者接受了降脂药物治疗,治疗药物主要包括贝特类、他汀类和ω-3脂肪酸等;19例患者经过药物治疗、停药等干预措施,TG水平降至2级以下。结论 临床实践中需重视卡培他滨对血脂代谢的影响,警惕严重HTG的发生,对于治疗前即存在血脂异常、糖尿病、肥胖等代谢性疾病以及绝经期女性应做好血脂监测,保障用药安全。
Abstract
OBJECTIVE To analyze the cases of severe hypertriglyceridemia caused by capecitabine reported in literature and found in our hospital, so as to understand the characteristics, prevention and intervention measures of this adverse reaction. METHODS Case reports of severe hypertriglyceridemia(HTG)caused by capecitabine were retrieved from PubMed and CMKI website database, and relevant information, such as patients′ basic information, capecitabine medication, triglyceride(TG)level,chronic disease,complication, lipid-lowering treatment, was extracted. Microsoft Excel 2013 was used to analyze the data. RESULTS Twenty-one cases of severe HTG(TG≥500 mg·dL-1) caused by capecitabine were reported in 14 literatures. A total of 23 cases were included in the analysis, including 2 cases found in our hospital. Among them, there were 10 males and 13 females. The mean age is (57.6±8.8)years. The TG level of 18 patients was grade 4, and that of 5 patients was grade 3. Twelve patients had basic diseases such as dyslipidemia, abnormal blood glucose or obesity; thirteen patients with hyperlipidemia were complicated with hypercholesterolemia, hyperglycemia or acute pancreatitis. Sixteen patients were treated with lipid-lowering drugs, including fibrates, statins and omega-3 fatty acids. After drug treatment, drug withdrawal and other interventions, the TG level of 19 patients decreased to below grade 2. CONCLUSION In clinical practice, attention should be paid to the effect of capecitabine on blood lipid metabolism, and the occurrence of severe hyperlipidemia should be vigilant. During capecitabine treatment, for patient with dyslipidemia, diabetes, obesity and other metabolic diseases, as well as menopausal women, blood lipid monitoring should be done to ensure the safety of patients.
关键词
卡培他滨 /
严重高脂血症 /
血脂异常 /
结直肠癌 /
乳腺癌
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Key words
capecitabine /
severe hypertriglyceridemia /
dyslipidemia /
colorectal cancer /
breast cancer
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中图分类号：
R969
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参考文献
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