【摘要】 目的 针对奥沙利铂过敏反应，临床多采用糖皮质激素、抗组胺药物及其组合等不同的方式进行抗过敏预处理，本研究旨在比较不同预处理方式对奥沙利铂过敏反应发生率的影响。方法 回顾性分析收集在复旦大学附属肿瘤医院使用含奥沙利铂方案进行门诊化疗的实体瘤患者，按照抗过敏预处理方式不同分为地塞米松单药预处理组(单药组)、地塞米松+异丙嗪双药预处理组(双药组)和地塞米松+异丙嗪+西咪替丁三药预处理组(三药组),比较三组之间过敏反应的发生情况差异。结果 共收集患者1 168例，其中单药预处理组446例，双药预处理组507例，三药预处理组215例。所有患者中发生过敏反应的有36例(3.08%),其中单药预处理组发生过敏的有17例(3.81%),中位过敏为4周期(范围1～8);双药预处理组发生过敏的有12例(2.37%),中位过敏为2周期(范围1～7);三药预处理组发生过敏的人数有7例(3.26%),中位过敏为3周期(范围2～7)。双药组与单药组相比，过敏反应发生率下降，但差异未达统计学显著性(单药组vs双药组：3.81%vs 2.37%,P=0.195);三药组与单药组相比，过敏反应发生率无明显差异(单药组vs双药组：3.81%vs 3.26%,P=0.720);三药组与双药组相比，过敏反应发生率增加，但差异未达统计学显著性(三药组vs双药组：3.26%vs 2.37%,P=0.495)。结论 异丙嗪联合地塞米松相比于单独使用地塞米松预处理，奥沙利铂过敏反应发生率更低，双药预处理对于预防奥沙利铂过敏有一定的保护作用；西咪替丁的加入对奥沙利铂过敏反应的预防没有起到保护作用，不推荐作为过敏反应的预处理药物。更多还原

【Abstract】 OBJECTIVE To compare the effects of different premedication regimens, such as glucocorticoids, antihistamines, and their combinations on the incidence of oxaliplatin hypersensitivity reactions(HSRs). METHODS Patients with solid tumors who received an oxaliplatin-containing regimen in Fudan University Affiliated Cancer Hospital were retrospectively collected and divided into three premedication groups. Patients who used single dexamethasone as premedication were classified as single-agent premedication group(single-agent group), and patients who used dexamethasone combined with promethazine as premedication were classified as double-agent premedication group(double-agent group), and patients who used dexamethasone + promethazine + cimetidine as premedication were classified as triple-agent premedication group(triple-agent group). The occurrence of HSRs was compared between different premedication groups. RESULTS A total of 1 168 patients were collected, including 446 in the single-agent group, 507 in the double-agent group, and 215 in the triple-agent group. Among all the patients 36 cases(3.08%) developed HSRs. Seventeen patients(3.81%) developed HSRs in the single-agent group, the median allergic cycle was 4(1-8); twelve patients(2.37%) developed HSRs in the double-agent group, the median allergic cycle was 2(1-7); seven patients(3.26%) developed HSRs in the triple-agent group, the median allergic cycle was 3(2-7). Compared with the single-agent group, the incidence of allergic reactions in the double-agent group decreased, but the difference was not statistically significant(single-agent group vs double-agent group: 3.81% vs 2.37%, P=0.195). There was no significant difference in the incidence of allergic reactions between the triple-agent group and the single-agent group(single-agent group vs triple-agent group: 3.81% vs 3.26%, P=0.720). CONCLUSION Compared with dexamethasone alone, promethazine combined with dexamethasone as premedication has a lower incidence of HSRs to oxaliplatin, suggesting a double-agent premedication regimen can be more effective in reducing HSRs to oxaliplatin, while the addition of cimetidine has no protective effect against oxaliplatin HSRs.更多还原