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目的:总结抗肿瘤药物引起的肺不良反应的类型、特点,探讨其产生的机制,并对此不良反应的诊断与治疗进行综述。方法:应用Medline、PubMed及CNKI期刊全文检索系统,以“抗肿瘤药物、肺不良反应和肺毒性”等为检索词,检索1981-2012年的相关文献。纳入标准:1)肺不良反应分类;2)肺不良反应的产生机制;3)肺不良反应的特点;4)肺不良反应的诊断与治疗。根据纳入标准分析文献24篇。结果:抗肿瘤药物引起的肺不良反应很常见,主要是由于药物对肺组织的直接损伤作用和免疫反应引起的,病理上表现为过敏性肺炎、肺水肿、间质性肺炎和肺纤维化,依赖用药史和排除其他原因进行诊断,至今也没有非常有效的治疗方法。结论:研究抗肿瘤药物引起的肺不良反应,可能为药物研发提供思路,为临床用药提供参考。
OBJECTIVE: To summarize the types and characteristics of adverse drug reactions caused by antineoplastic agents and to explore the mechanism of their occurrence. The diagnosis and treatment of this adverse reaction are reviewed. Methods: The full text search system of Medline, PubMed and CNKI journals was used to search the relevant literature from 1981 to 2012 with the search term of “antineoplastic drugs, pulmonary adverse reactions and pulmonary toxicity”. Inclusion criteria: 1) classification of adverse drug reactions; 2) the mechanism of adverse drug reactions; 3) the characteristics of adverse pulmonary reactions; 4) the diagnosis and treatment of adverse pulmonary reactions. Based on inclusion criteria, 24 articles were analyzed. Results: The adverse drug reactions caused by anticancer drugs were common, mainly due to the direct damage caused by the drugs to the lung tissue and the immune reaction. The pathological manifestations were allergic pneumonia, pulmonary edema, interstitial pneumonia and pulmonary fibrosis. There is no very effective treatment to date depending on the history of medication and the exclusion of other causes. Conclusion: The study of adverse drug reactions caused by anticancer drugs may provide ideas for drug development and provide reference for clinical use.