| 摘要: |
| ［摘要］ 目的 探索较好的预防紫杉醇过敏反应的小剂量地塞米松预处理方案。方法 选择2014-04～2016-07应用紫杉醇联合顺铂方案预计能够完成4周期化疗的374例患者,实际入组356例，随机分为A组180例，B组176例。A组患者晚10点，次晨6点各口服地塞米松7.5 mg，滴注紫杉醇前30 min静脉注射地塞米松5 mg。B组滴注紫杉醇前30 min静脉注射地塞米松10 mg。比较两组紫杉醇过敏反应及其他常见不良反应发生人数有无差异。结果 两组患者发生过敏反应绝大多数在前2个周期，比率分别为85.7%、81.5%（P>0.05），均无4、5级过敏反应发生。A、B两组患者发生1、2、3级过敏反应的人数分别为11例、7例、0例和12例、8例、5例（P>0.05）。两组患者均无4、5级周围神经炎发生，无4级肌肉关节痛及恶心呕吐发生。A、B两组患者发生1、2、3级周围神经炎的人数分别为45例、26例、6例和39例、30例、9例（P>0.05）；发生1、2、3级肌肉关节痛的人数分别为47例、24例、17例和40例、31例、20例（P>0.05）；发生1、2、3级恶心呕吐的人数分别为29例、17例、6例和34例、21例、11例（P>0.05）。A、B两组患者空腹血糖升高人数分别为8例、1例（P<0.05），失眠症发生人数分别为17例、5例（P<0.05）。结论 B组小剂量地塞米松预处理方案可能是较好的用药方案。 |
| 关键词: 小剂量地塞米松 紫杉醇 化学治疗 预处理方案 过敏反应 |
| DOI：10.3969/j.issn.1674-3806.2018.01.09 |
| 分类号:R 730 |
| 基金项目: |
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| Comparison of two different low dosages of dexamethasone premedication procedures in prevention of allergic reaction of paclitaxel |
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DONG Bo-sheng, XU Ke-you, ZUO Cai-ying
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Department of Medical Oncology, Zhoukou Central Hospital, Henan 466000, China
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| Abstract: |
| ［Abstract］ Objective To explore a better premedication procedure of low dosage of dexamethasone to prevent the allergic reaction of paclitaxel.Methods 374 patients who were expected to be able to complete 4 cycles of paclitaxel combined with cisplatin chemotherapy regimen were collected from April 2014 to July 2016,of whom 356 patients were actually enrolled in this study. They were randomly divided into group A and group B. Group A(n=180) received dexamethasone 7.5 mg orally at 10:00 in the evening and 6:00 in the next morning and were injected with dexamethasone 5 mg via vein 30 minutes earlier before injection of paclitaxel. Group B(n=176) were injected with dexamethasone 10 mg via vein 30 minutes earlier before injection of paclitaxel. The rates of allergic reactions and other common adverse reactions were compared between the two groups.Results The majority of the allergic reactions happened in the first two chemotherapy cycles and the incidence rates were 85.7% and 81.5% in group A and group B respectively(P>0.05). The allergic reactions of grade 4 or 5 didn′t occur in the two groups. The number of the patients suffered from allergic reactions of grade 1, 2 or 3 was 11, 7 or 0 and 12, 8 or 5 in group A and group B respectively(P>0.05). The peripheral neuritis of grade 4 or 5, the muscle and joint pain of grade 4, the nausea and vomiting of grade 4 didn′t occur in the two groups. The number of the patients suffering from peripheral neuritis of grade 1, 2 or 3 was 45, 26 or 6 and 39, 30 or 9 in group A and group B respectively(P>0.05). The number of muscle and joint pain of grade 1, 2 or 3 was 47, 24 or 17 and 40, 31 or 20(P>0.05) and the number of nausea and vomiting of grade 1, 2 or 3 was 29, 17 or 6 and 34, 21 or 11(P>0.05) in group A and group B respectively. The number of the patients suffering from increasing of fasting blood-glucose was 8 and 1（P<0.05） and the number of insomnia was 17 and 5（P<0.05） in group A and group B respectively.Conclusion Premedication procedure of low dosage of dexamethasone may be a better choice for the patients with allergic reaction of paclitaxel. |
| Key words: Low dosage of dexamethasone Paclitaxel Chemotherapy Premedication procedure Allergic reaction |
