摘要
目的探讨免疫检查点抑制剂相关性糖尿病(ICI-DM)的临床特点及危险因素,为减少其发生及早期识别与干预提供参考。方法回顾性收集2021年1月至2024年6月首都医科大学附属北京同仁医院接受免疫检查点抑制剂治疗的住院患者的临床资料信息,包括性别、年龄、肿瘤分期、免疫检查点抑制剂的种类、用药前血糖水平、既往病史、放化疗史、合并用药等,分析ICI-DM可能的危险因素。结果共纳入患者372例,发生ICI-DM共26例(6.99%),根据患者是否发生ICI-DM分为ICI-DM组(irD组)26例和无ICI-DM组(无irD组)289例。单因素分析结果显示,ICI-DM与患者年龄、用药疗程、用药前空腹血糖水平、诊断以头颈肿瘤为主、合并高血压、合并高脂血症、联合化疗尤其是联合应用糖皮质激素以及联合应用紫杉醇+铂类化疗药物有关(P<0.05)。logistic回归分析显示,年龄、用药疗程、合并高脂血症、联合应用糖皮质激素是发生ICI-DM的独立危险因素,头颈肿瘤和联合应用紫杉醇+铂类化疗药物为ICI-DM的保护因素(P<0.05)。结论尽早识别ICIDM高危人群,及时启动干预措施,可减少并延缓ICI-DM的发生和进展。
Objective To explore the clinical characteristics and risk factors of Immune checkpoint inhibitor-associated diabetes mellitus(ICI-DM)so as to provide reference for reducing its occurrence,early recognition and intervention.Methods Clinical data of 372 inpatients treated with immune checkpoint inhibitors from Beijing Tongren Hospital Affiliated to Capital Medical University from January 2021 to June 2024 were retrospectively collected,including sex,age,tumor stage,type of immune checkpoint inhibitors,blood glucose level before medication,past medical history,history of chemoradiotherapy,combined medication,etc.The possible risk factors of ICI-DM were analyzed.Results A total of 372 patients were included,among which 26 cases(6.99%)developed ICI-DM.According to whether the patients developed ICI-DM,they were divided into 26 cases in ICI-DM group(irD group)and 289 cases in no ICI-DM group(non-irD group).Univariate analysis showed that ICI-DM was correlated with patient age,medication duration,fasting blood glucose level before medication,head and neck tumor as the main diagnosis,hypertension combined with hyperlipidemia combined with chemotherapy,especially glucocorticoid combined with paclitaxel combined with carboplatin regimen(P<0.05).Logistic regression analysis showed that age,duration of medication,combination of hyperlipidemia and combined application of glucocorticoids were independent risk factors for ICI-DM,while head and neck tumor and combined application of paclitaxel combined with platinum-based chemotherapy drugs were protective factors for ICI-DM(P<0.05).Conclusion Early identification of high-risk groups of ICI-DM and timely initiation of intervention measures can reduce and delay the occurrence and progression of ICIDM.
作者
商红建
胡卿源
刘薇
宋智慧
SHANG Hongjian;HU Qingyuan;LIU Wei;SONG Zhihui(Department of Pharmacy,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Endorine,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《临床药物治疗杂志》
2024年第12期16-21,共6页
Clinical Medication Journal
关键词
免疫检查点抑制剂
糖尿病
高脂血症
不良反应
immune checkpoint inhibitor
diabetes mellitus
hyperlipidemia
adverse reaction
