目的 分析貝伐珠單抗致血栓栓塞的臨床特點，為臨床安全用藥提供參考。方法 以“貝伐珠單抗”“血栓”“栓塞”“不良反應”“bevacizumab”“thrombus”“embolism”“thromboembolism”“adverse reactions”為檢索詞，檢索中國知網、萬方、維普和PubMed、Web of Science文獻數據庫建庫至2025年1月收載的貝伐珠單抗致血栓栓塞的案例報道，對報道中的患者性別、年齡、國籍、原患疾病、貝伐珠單抗的用法用量、聯合用藥情況、患者用藥前有無血栓栓塞、血栓栓塞發(fā)生時間、類型、累及部位、干預及轉歸等進行描述性統計分析。結果 共納入文獻24篇，涉及患者24例，其中男性13例（54.17%），女性11例（45.83%），年齡分布在25～79歲，平均58歲。23例患者原患疾病為惡性腫瘤，其中結直腸癌和肺癌居多，并全部聯用其他化療藥物；1例患者原患疾病為黃斑變性伴視網膜出血，使用貝伐珠單抗單藥治療。24例患者中發(fā)生靜脈血栓栓塞14例，動脈血栓栓塞8例，動脈血栓合并靜脈血栓栓塞2例。16例患者經停藥和/或對癥處理后好轉，7例患者死亡，1例未描述，可見其潛在的致死風險。結論 臨床工作中應重視貝伐珠單抗致血栓栓塞的不良反應，尤其是動脈血栓栓塞。加強用藥監(jiān)護和患者隨訪，確保臨床用藥安全。

Objective To analyze the clinical manifestations and characteristics of adverse reactions related to thromboembolism induced by bevacizumab, and provide reference for its safe clinical use. Methods Case reports of thromboembolism induced by bevacizumab in the CNKI, Wanfang, VIP, PubMed, and Web of Science from the inception of these databases to January 2025 were searched by using “bevacizumab” “thrombosis” “embolism” “adverse reactions” “bevacizumab” “thrombosis” “embolism” “adverse reactions” as search terms. Statistical analysis was conducted on the gender, age, nationality, underlying disease, usage and dosage of bevacizumab, combination therapy, presence of thromboembolism before medication, time, type, affected area, intervention and outcome of thromboembolism of patients. Results A total of 24 literatures were included, involving 24 patients, including 13 males (54.17%) and 11 females (45.83%), ranging in age from 25 to 79 years old, with an average age of 58 years old. The primary disease of 23 patients was malignant tumor, mostly colorectal cancer, and lung cancer, and all of them were treated with other chemotherapy drugs. One patient had macular degeneration with retinal hemorrhage and was treated with bevacizumab monotherapy. Among the 24 patients, venous thromboembolism occurred in 14 cases, arterial thromboembolism in 8 cases, and arterial thromboembolism combined with venous thromboembolism in two cases. 16 Patients improved after discontinuation and/or symptomatic management, 7 died and one was not described, indicating the potential risk of death. Conclusion Clinical workers should pay attention to the adverse reaction of thromboembolism induced by bevacizumab, especially arterial thromboembolism. Strengthen medication monitoring and patient follow-up to ensure the safety of clinical medication.

R979.1

山東省醫(yī)學會臨床科研資金-齊魯專項（YXH2022ZX02067）