目的:分析雷莫芦单抗致血管瘤的临床特点，为临床安全合理用药提供参考。方法:检索中国知网、维普、万方和PubMed、Web of Science等数据库收载的雷莫芦单抗致血管瘤病例报告，进行描述性统计分析。结果:收集雷莫芦单抗致血管瘤患者共14例，男性9例(64。3％)，女性5例(35。7％)，年龄40～76岁，平均62岁。原发病为胃癌者7例，肺癌3例，胃食管交界腺癌、结直肠癌各2例。14例患者中联合紫杉醇者9例，联合其他抗肿瘤药物5例。开始应用雷莫芦单抗至出现血管瘤的时间为10d至7个月，其中≤3个月者10例。血管瘤类型包括化脓性肉芽肿10例(71。4％)，樱桃状血管瘤、毛细血管瘤各2例，丛状血管瘤1例，其中1例同时出现化脓性肉芽肿和樱桃状血管瘤。化脓性肉芽肿临床表现为突出于皮肤或黏膜表面孤立的红色丘疹或带蒂结节样肿物，增长迅速且质脆易出血;其他血管瘤则表现为大小不一的红色丘疹或斑块。组织病理学主要表现为毛细血管扩张或增生，伴或不伴炎性细胞浸润或水肿。11例患者有干预及转归记录，经停药和/或手术治疗后病变好转，继续用药血管瘤可能持续进展。结论:雷莫芦单抗致血管瘤多发生于用药后3个月内，以化脓性肉芽肿居多。临床医师和药师应重视该不良反应，在治疗过程中做好用药监护和患者随访，以保证临床用药安全。
Literature analysis of hemangioma induced by ramucirumab
OBJECTIVE To analyze the clinical characteristics of hemangioma induced by ramucirumab,and provide refer-ence for clinical rational use.METHODS Case reports on hemangioma induced by ramucirumab were collected from the data-bases of CNKI,VIP,Wanfang,PubMed and Web of Science.Descriptive analysis was conducted on the clinical data of patients.RESULTS A total of 14 patients were enrolled in this study,including 9 males(64.3％)and 5 females(35.7％),aged from 40 to 76 years with an average age of 62 years.The primary diseases were gastric cancer(7 cases),lung cancer(3 cases),gastro-esophageal junction adenocarcinoma(2 cases)and colorectal cancer(2 cases).Among the 14 patients,9 were combined with paclitaxel and 5 were combined with other antitumor drugs.The occurrence time of hemangioma was 10 days to 7 months after ramucirumab administration and it was ≤ 3 months in 10 patients.The types of hemangioma included 10 cases of pyogenic granu-loma(71.4％),2 cases of cherry angioma,2 cases of capillary hemangioma,1 case of tufted angioma.Among them,1 case pre-sented with both pyogenic granuloma and cherry angioma.The clinical manifestations of pyogenic granuloma were isolated red papules or pedicled nodular-like masses protruding from the skin or mucous surface,which had rapid growth,brittle quality and prone to bleeding.Other hemangiomas presented red papules or plaques of varying size.The main histopathological manifesta-tions were telangiectasia or hyperplasia,with or without inflammatory cell infiltration or edema.Totally 11 patients had interven-tion and outcome records.Patients'vascular lesion improved after drug withdrawal and/or surgical treatment,but the heman-gioma might continue to progress if ramucirumab continued to use.CONCLUSION Hemangiomas induced by ramucirumab often occur within 3 months after treatment,most of which are pyogenic granuloma.Clinicians and pharmacists should pay atten-tion to this adverse reaction,and medication monitoring and patient follow-up are necessary to ensure clinical medication safety during the treatment.
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