Adverse drug reaction (ADR) in PET/CT examination of 18F-PSMA-1007 prostate cancer
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摘要:
目的对18F-PSMA-1007这一新型示踪剂用于前列腺癌PET/CT检查时出现的药品不良反应进行回顾性分析,根据此类示踪剂的特点提出针对性的解决流程,并验证其效果。 方法筛选2019年5~8月行18F-PSMA-1007 PET/CT检查的58例患者作为观察组,使用针对18F-PSMA-1007示踪剂增加了预检筛查及示踪剂注射前稀释的检查流程。回顾性随机抽取2019年1~4月使用常规检查流程的58例患者作为对照组。观察组患者年龄25~75岁(52.65±2.77岁),对照组患者年龄29~79岁(62.91±2.35岁)。两组患者均为男性,一般资料差异无统计学意义(P > 0.05)。计算两组患者同类药品不良反应的发生率并进行统计学分析。 结果对照组58例患者中出现示踪剂注射时刺激痛的患者16例(27.59%),出现注射示踪剂后不适的患者3例(5.17%),出现示踪剂特异性低摄取致图像对比度无法满足诊断需要的患者2例(3.45%);观察组患者中出现上述药品不良反应的人数及发生率分别为2例(3.45%)、1例(1.72%)、0例(0%);观察组各药品不良反应的发生概率均小于对照组(P < 0.05)。 结论应用针对此类示踪剂而制定的预检筛查及示踪剂注射前稀释流程可以大大降低前列腺癌患者18F-PSMA-1007 PET/CT检查时药品不良反应的发生率,保证检查的成功率。 -
关键词:
- 氟标前列腺特异性膜抗原 /
- PET/CT /
- 药品不良反应发生率 /
- 流程优化
Abstract:ObjectiveTo analyze the adverse drug reaction (ADR) of 18F-PSMA-1007 as a new tracer in PET/CT examination of prostate cancer, and propose a specific solution according to the characteristics of this tracer. MethodsFifty-eight patients with 18F-PSMA-1007 PET/CT from May 2019 to August 2019 were selected as the observation group according to the inclusion criteria. The use of 18F-PSMA-1007 tracer added the inspection procedure of pre-screening and tracer dilution before injection. A total of 58 patients using the routine examination procedure were randomly selected as the control group. The patients in the observation group were 25-75 years old, with an average age of 52.65±2.77 years old. The patients in the control group were 29-79 years old, with an average age of 62.91±2.35 years old. The patients in the two groups were all males, and there was no significant difference of other general data between two groups. The incidence of similar ADR was compared between the two groups. ResultsAmong the 58 patients in the control group, there were 16 patients (27.59%) with pain caused by tracer injection. Discomfort after injection of tracer was found in 3 patients, accounting for 5.17%. There were 2 cases (3.45%) of the patients with low specific uptake of tracer, whose image contrast could not meet the diagnostic requirements. The number and incidence of the ADR events in the observation group were: 2 cases (3.45%), 1 case (1.72%), 0 case (0%). The occurrence probability of each adverse event in the control group was lower than that in the observation group (P < 0.05). ConclusionApplication of pre-screening and pre-injection dilution of the tracer can greatly reduce the incidence of ADR in 18F-PSMA-1007 PET/CT examination of prostate cancer patients. It ensure the success rate of the examination. -
Key words:
- 18F-PSMA-1007 /
- PET/CT /
- incidence of ADR /
- process optimization
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表 1 药品不良反应分析表
Table 1. Analysis of ADR
药品不良反应 原因分析 改进流程 (1)注射部位刺激 18F-PSMA-1007药液中残留的溶剂乙醇,对血管有刺激进而产生注射部位疼痛 对药物行等比活度稀释,降低乙醇的残存量至乙醇浓度V/V≤0.5:99.5 (2)注射示踪剂后发生不适 患者存在乙醇过敏
患者体内药物与乙醇出现双硫仑样反应制定酒精过敏筛查问卷表(表 2)对患者行酒精过敏筛查对能引起双硫仑样反应的检查前用药做详细病史询问 (3)图像对比度过低无法满足诊断需要 检查前使用导致患者体内PSMA表达抑制或雄激素受体抑制的药物,导致示踪剂特异性吸收降低 对多西他赛、恩杂鲁胺等相关药物做检查前详细病史询问 表 2 两组患者药品不良反应发生概率统计表(%,n=58)
Table 2. Statistical table of occurrence probability of ADR in the two groups
组别 注射部位刺激 注射示踪剂后发生不适 图像对比度无法满足诊断 对照组 27.59 5.17 3.45 观察组 3.45 1.72 0 χ2 1.27 2.28 2.13 P 0.00 0.03 0.00 -
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