目的 調(diào)查2020—2021年徐州市中心醫(yī)院抗腫瘤藥物嚴(yán)重不良反應(yīng)（ADR）發(fā)生情況，并分析相關(guān)危險(xiǎn)因素。方法 回顧性調(diào)查徐州市中心醫(yī)院2020年1月—2021年12月抗腫瘤藥物嚴(yán)重ADR患者一般情況、抗腫瘤藥物種類及分布、嚴(yán)重ADR的發(fā)生時(shí)間和給藥途徑、累及系統(tǒng)或器官以及嚴(yán)重程度分布情況。采用單因素和多因素Logistic回歸分析影響抗腫瘤藥物嚴(yán)重不良反應(yīng)發(fā)生的相關(guān)因素。結(jié)果 119例患者共接受538例次抗腫瘤藥物治療，共90例患者在化療過(guò)程發(fā)生195例次嚴(yán)重ADR，其中男性39例發(fā)生75例次嚴(yán)重ADR，女性51例發(fā)生120例次嚴(yán)重ADR。嚴(yán)重ADR以累及血液系統(tǒng)和消化系統(tǒng)最多，分別為107例次（54.87%）和49例次（25.13%）；Ⅲ級(jí)和Ⅳ級(jí)ADR分別為136例次（69.74%）和59例次（30.26%）。單因素分析結(jié)果顯示，ADR和非ADR組患者平均年齡、性別、合并肝功能損害、合并腎功能損害、合并慢性病、單次給藥、給藥途徑等存在顯著差異（P＜0.05）。Logistic回歸分析發(fā)現(xiàn)，年齡、性別、肝功能損害、腎功能損害、合并慢性病、單次給藥、給藥途徑是造成腫瘤患者發(fā)生抗腫瘤藥物嚴(yán)重ADR的危險(xiǎn)因素（P＜0.05）。結(jié)論 對(duì)于合并風(fēng)險(xiǎn)因素的腫瘤患者需在給予抗腫瘤藥物治療前進(jìn)行嚴(yán)重ADR綜合評(píng)估和藥師咨詢，制定合理用藥方案，并在治療過(guò)程中應(yīng)監(jiān)測(cè)血藥濃度和嚴(yán)重ADR情況，以達(dá)到減少嚴(yán)重ADR發(fā)生和減輕其程度的目的。

Objective To investigate the serious ADR of antineoplastic drugs in Xuzhou Central Hospital from 2020 to 2021, and to analyze the relevant risk factors. Methods The general situation, types and distribution of antineoplastic drugs, occurrence time and route of severe ADRs, involved systems or organs, and distribution of severe ADRs were retrospectively investigated in Xuzhou Central Hospital from January 2020 to December 2021. Univariate and multivariate Logistic regression were used to analyze the factors influencing the occurrence of serious adverse reactions of antineoplastic drugs. Results 119 patients received 538 cases of chemotherapy and anti-tumor drugs. A total of 90 patients had 195 cases of serious ADR during chemotherapy. 39 male patients had 75 cases of serious ADR, and 51 female patients had 120 cases of serious ADR. The most serious ADR involved the blood system and digestive system, 107 (54.87%) and 49 (25.13%) respectively. Class III and class IV ADR were 136 (69.74%) and 59 (30.26%) respectively. Univariate analysis showed that there were significant differences between ADR and non-ADR groups in average age, gender, combined liver function impairment, combined renal function impairment, combined chronic disease, single dose and route of administration (P < 0.05). Logistic regression analysis showed that age, gender, liver function damage, renal function damage, combined with chronic diseases, single administration, and route of administration were the risk factors for serious ADR of antineoplastic drugs in tumor patients (P < 0.05). Conclusion For cancer patients with risk factors, a comprehensive assessment of serious ADR and pharmacist consultation should be conducted before antineoplastic drug treatment, rational drug use plan should be formulated, and blood drug concentration and serious ADR should be monitored during treatment, so as to reduce the occurrence and degree of serious ADR.

R979.1