1例伊立替康致迟发性腹泻的病例分析.pdf

中国药师　 　 2016 年第19 卷第3 期　 　 China Pharmacist 2016 , Vol. 19　 No. 03 1例伊立替康致迟发性腹泻的病例分析 1 2 3 1 1 4 1 夏晖　 王璇 　 王之彝 　 朱红 　 曹明雪　 王黎黎 　 刘峰群 　 (1. 解放军第302 医院药学部　 北京 100039 ;2. 第三军医大学第二附属医院药学部;3. 第三军医大学第二附属医院肿瘤科;4 . 解放军93253 部队保障部卫生队) 摘　 要　 目的:探讨1 例伊立替康导致的迟发性腹泻。 方法:分析导致患者发生迟发性腹泻的原因,机制,遗传因素和治疗。 结果:迟发性腹泻是伊立替康的剂量限制性毒性,与其代谢产物7-乙基-10-羟基喜树碱(SN-38 )的细胞毒性有关。 基因多态 性是伊立替康相关迟发性腹泻的重要因素之一。 该患者腹泻的治疗方案安全有效,临床药师在治疗过程中发挥了重要作用。 结论:加强伊立替康用药患者的药学监护十分重要。 关键词　 伊立替康;迟发性腹泻;洛哌丁胺;药学监护;临床药师 中图分类号:R979. 1　 文献标识码:A　 　 文章编号:1008-049X (2016 )03-0543-03 Analysis of One Case of Irinotecan-induced Delayed Diarrhea 1 2 3 1 1 4 1 Xia Hui ,Wang Xuan ,Wang Zhiyi ,Zhu Hong ,Cao Mingxue ,Wang Lili ,Liu Fengqun (1. Department of Pharmacy , No. 302 Hos- pital of PLA , Beijing 100039 , China ; 2. Department of Pharmacy , Xinqiao Hospital , the Second Affiliated Hospital of the Third Mili- tary Medical University ; 3. Department of Oncology Disease , Xinqiao Hospital , the Second Affiliated Hospital of the Third Military Medical University ; 4 . Medical Team of Supportment Department , 93253 Troop of PLA ) ABSTRACT　 Objective: To analyze one case of delayed diarrhea caused by irinotecan. Methods: The pathogeny , mechanism , ge- netics and treatment of the case were analyzed. Results: Delayed diarrhea was the dose-limited toxicity of irinotecan , which was related with the cytotoxicity of the active metabolite 7-ethyl-10-hydroxycamptothecin (SN-38 ). Genetic polymorphism was one of important risk factors , especially UGT1A1 polymorphisms could be used as a predictor for the diarrhea. The pharmacotherapy of the diarrhea was ef- fective and rational , and the clinical pharmacist provided rational pharmaceutical care for the patient. Conclusion: It is very important to enha