新型口服抗凝药致间质性肺病的文献病例分析
Literature Case Analysis of Interstitial Lung Disease Induced by Novel Oral Anticoagulants
韩强 1张蕾 2龚银华 1朱建国 1谢诚1
作者信息
- 1. 苏州大学附属第一医院药学部,江苏苏州 215000
- 2. 河南省安阳市人民医院药学部,河南安阳 455099
- 折叠
摘要
目的 探讨新型口服抗凝药(novel oral anticoagulants,NOACs)致间质性肺病(interstitial lung disease,ILD)的发生情况和特点,为临床用药安全提供参考.方法 检索PubMed、Embase、中国知网、万方和维普数据库自建库至2023年3月收录的有关NOACs致ILD的病例报道并对相关信息和数据进行整理分析.结果 共纳入8篇文献合计11例患者,均为男性,年龄65～91(79.6±7.1)岁,其中涉及阿哌沙班和达比加群酯各5例,艾多沙班1例.所有患者均伴有呼吸困难且经影像学检查后诊断为ILD,其中以弥漫性肺泡出血相对多见.发生IDL距首次用药最短3 d,最长4年.经停药、机械通气和甲泼尼龙冲击等治疗后9例转归良好,2例最终死于呼吸衰竭.结论 不同NOACs均可致ILD,用药初期应密切关注有无呼吸困难等症状,必要时行影像学检查,一旦怀疑为NOACs所致ILD应及时停药并采取适当的措施如糖皮质激素等治疗.
Abstract
OBJECTIVE To explore the occurrence and characteristics of interstitial lung disease(ILD)induced by novel oral anticoagulants(NOACs)and provide references for clinical safe drug use.METHODS The case reports of ILD induced by NOACs published in PubMed,Embase,CNKI,Wanfang and VIP were searched from the establishment of each database to March 2023,and statistical analysis was conducted on relevant information and data.RESULTS A total of 11 male patients from 8 articles were identified and included in the analysis,including 5 cases of apixaban,5 cases of dabigatran etexilate and 1 case of edoxaban.The age of the patients was 65-91(79.6±7.1)years old.All patients suffered from dyspnea and were diagnosed with ILD after imaging examination,in which diffuse alveolar hemorrhage was relatively common.ILD was found from 3 days to 4 years after medication.After treatment including drug withdrawal,mechanical ventilation and methylprednisolone pluse therapy,9 cases had good prognosis and 2 cases died of respiratory failure.CONCLUSIONS ILD could be induced by different NOACs.Attention should be paid to dyspnea and other symptoms at the early stage of treatment,and imaging examina-tion should be performed when necessary.Once ILD was suspected to be caused by NOACs,withdraw in time and appropriate measures such as glucocorticoid should be taken.
关键词
新型口服抗凝药/间质性肺病/药品不良反应/文献病例分析Key words
novel oral anticoagulant/interstitial lung disease/adverse drug reaction/literature case analysis引用本文复制引用
基金项目
国家临床重点专科(临床药学)建设项目(国卫办医函[2018]292号)
国家卫生健康委属(管)医疗机构临床学科重点项目建设专项资金()
出版年
2024
NETL
NSTL
万方数据