目的 分析贝伐珠单抗致血栓栓塞的临床特点，为临床安全用药提供参考。方法 以“贝伐珠单抗”“血栓”“栓塞”“不良反应”“bevacizumab”“thrombus”“embolism”“thromboembolism”“adverse reactions”为检索词，检索中国知网、万方、维普和PubMed、Web of Science文献数据库建库至2025年1月收载的贝伐珠单抗致血栓栓塞的案例报道，对报道中的患者性别、年龄、国籍、原患疾病、贝伐珠单抗的用法用量、联合用药情况、患者用药前有无血栓栓塞、血栓栓塞发生时间、类型、累及部位、干预及转归等进行描述性统计分析。结果 共纳入文献24篇，涉及患者24例，其中男性13例（54.17%），女性11例（45.83%），年龄分布在25～79岁，平均58岁。23例患者原患疾病为恶性肿瘤，其中结直肠癌和肺癌居多，并全部联用其他化疗药物；1例患者原患疾病为黄斑变性伴视网膜出血，使用贝伐珠单抗单药治疗。24例患者中发生静脉血栓栓塞14例，动脉血栓栓塞8例，动脉血栓合并静脉血栓栓塞2例。16例患者经停药和/或对症处理后好转，7例患者死亡，1例未描述，可见其潜在的致死风险。结论 临床工作中应重视贝伐珠单抗致血栓栓塞的不良反应，尤其是动脉血栓栓塞。加强用药监护和患者随访，确保临床用药安全。

Objective To analyze the clinical manifestations and characteristics of adverse reactions related to thromboembolism induced by bevacizumab, and provide reference for its safe clinical use. Methods Case reports of thromboembolism induced by bevacizumab in the CNKI, Wanfang, VIP, PubMed, and Web of Science from the inception of these databases to January 2025 were searched by using “bevacizumab” “thrombosis” “embolism” “adverse reactions” “bevacizumab” “thrombosis” “embolism” “adverse reactions” as search terms. Statistical analysis was conducted on the gender, age, nationality, underlying disease, usage and dosage of bevacizumab, combination therapy, presence of thromboembolism before medication, time, type, affected area, intervention and outcome of thromboembolism of patients. Results A total of 24 literatures were included, involving 24 patients, including 13 males (54.17%) and 11 females (45.83%), ranging in age from 25 to 79 years old, with an average age of 58 years old. The primary disease of 23 patients was malignant tumor, mostly colorectal cancer, and lung cancer, and all of them were treated with other chemotherapy drugs. One patient had macular degeneration with retinal hemorrhage and was treated with bevacizumab monotherapy. Among the 24 patients, venous thromboembolism occurred in 14 cases, arterial thromboembolism in 8 cases, and arterial thromboembolism combined with venous thromboembolism in two cases. 16 Patients improved after discontinuation and/or symptomatic management, 7 died and one was not described, indicating the potential risk of death. Conclusion Clinical workers should pay attention to the adverse reaction of thromboembolism induced by bevacizumab, especially arterial thromboembolism. Strengthen medication monitoring and patient follow-up to ensure the safety of clinical medication.

R979.1

山东省医学会临床科研资金-齐鲁专项（YXH2022ZX02067）