摘要
目的 分析卡瑞利珠单抗致免疫相关性心肌炎的临床特点及诊治方案。方法 分析1例应用卡瑞利珠单抗治疗肝细胞癌诱发免疫相关性心肌炎的病例,检索相关文献,总结其临床特点及诊治方案。结果 该例患者免疫相关性心肌炎可能为卡瑞利珠单抗所致药品不良反应。其发生机制可能与T淋巴细胞激活过程平衡被打破,导致部分器官或组织内免疫反应异常增强,损害正常组织或器官有关。结论 应用卡瑞利珠单抗治疗过程中,需关注患者的临床症状和心肌酶谱等相关基线检查,并进行心功能等常规监测,鉴别其可能导致的免疫相关性心肌炎;一旦发生免疫相关性不良反应,应根据其严重程度及时完善心功能相关检查,并给予大剂量激素,同时警惕再次给药后的复发致死风险。
Objective To analyze the clinical characteristics,diagnosis and treatment of immune-associated myocarditis induced by camrelizumab.Methods A case of immune-associated myocarditis induced by hepatocellular carcinoma treated with camrelizumab was analyzed,and relevant literature was searched to summarize the clinical characteristics,diagnosis and treatment of this disease.Results The immune-associated myocarditis of the patient might be an adverse drug reaction induced by camrelizumab,and its mechanism might be related to the abnormal enhancement of immune response in some organs or tissues and the damage of normal tissues or organs induced by the imbalance of T lymphocyte activation process.Conclusion During the application of camrelizumab,it is necessary to pay attention to the clinical symptoms and related baseline examinations such as myocardial enzyme spectrum of patients,and carry out routine monitoring such as cardiac function examination to identify the immune-associated myocarditis that may be induced by camrelizumab. Once a patient has immune-associated adverse reactions,we should carry out cardiac function examination according to the severity of the above adverse reactions,and give large doses of hormones.At the same time,we should be vigilant the risk of death induced by recurrence after readministration.
作者
张维
艾超
冀召帅
张雅鑫
毛乾泰
ZHANG Wei;AI Chao;JI Zhaoshuai;ZHANG Yaxin;MAO Qiantai(Department of Pharmacy,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University·School of Clinical Medicine,Tsinghua University,Beijing,China 102218)
出处
《中国药业》
CAS
2022年第17期118-121,共4页
China Pharmaceuticals
