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| 題 名 | Naproxen於腫瘤熱的診斷與治療=Naproxen Used in Diagnosis and Treatment of Neoplastic Fever |
|---|---|
| 作 者 | 蔡奕萱; 曹惠良; 劉錦鳳; 劉彥廷; | 書刊名 | 藥學雜誌 |
| 卷 期 | 35:1=138 2019.03[民108.03] |
| 頁 次 | 頁65-68 |
| 分類號 | 418.224 |
| 關鍵詞 | 腫瘤熱; 副腫瘤症候群; NSAID類藥物; Naproxen; Neoplastic fever; NSAID; Naproxen test; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 腫瘤熱 (neoplastic fever) 是由惡性腫瘤本身引起的一種副腫瘤症候群,是發生於癌 症之非感染性發燒的最常見原因。腫瘤熱的已知機轉包括釋放細胞激素 (cytokines): 腫瘤壞死因子 (tumor necrosis factor;TNF)、間白質素1 (interleukin 1;IL-1)、間白質 素6 (interleukin 6;IL-6) 和干擾素 (Interferons;IFN),促使下視丘將體溫往上調整。 臨床特徵常見出汗紅腫,但比較沒有寒顫,心動過速或低血壓的現象。腫瘤熱的診 斷常需運用排除法,本文列出六種相關診斷條件。根據臨床經驗,naproxen 的早期試 驗不但價格相對便宜,而且可提供良好的控制。一篇2011年的隨機試驗 (randomized trial) 研究顯示,naproxen 與其他 NSAID 類藥物相比,有較快的療效,而 Indomethacin 只有暫時性的效果,metamizole 則是無效。另一個回顧性研究觀察到,steroids 對於 neoplastic fever 的緩解效果不如 naproxen, 39位腫瘤熱患者給予 naproxen,有36位 完全退燒;選取其中12位使用 naproxen 完全退燒病人,下次腫瘤熱發生時單獨使用 steroids,只有6位完全退燒。 |
| 英文摘要 | Neoplastic fever, a paraneoplastic syndrome caused by malignant tumor, is considered as the most common cause of non-infectious pyrexia.Possible pathophysiology of neoplastic fever involves the release of cytokines such as tumour necrosis factor, interleukin 1, interleukin 6 and interferons, which increase the hypothalamic temperature set-point. Sweating and skin flush are common clinical features; whereas, chill, bradycardia and hypotension are seldom or rarely associated with neoplastic fever. The diagnosis of neoplastic fever is done by exclusion and six diagnostic criteria are usually used while naproxen trial is one of them. Naproxen, when compared with other non-steroid anti-inflammatory drugs (NSAID) in neoplastic fever control, has been proven its value in a randomized trial conducted by Tsavaris et al. Indomethacin had only temporary effect and metamizole failed to have an effect. Naproxen was the best choice as it had faster therapeutic effect. In another retrospective study conducted by Chang et al. showed that effect of steroids for neoplastic fever is still inferior to that of Naproxen. Therefore, in clinical practice, if NSAIDs are tolerable, naproxen has been proven to exhibit better control for neoplastic fever and lower cost in early trials. |
本系統中英文摘要資訊取自各篇刊載內容。