在非小细胞肺癌患者的PD-1抑制剂相关心肌炎
Yuwen He1, Wanwen Chen1, Junying Cai1
1Department of Pharmacy, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Journal of thoracic disease
|October 23, 2023
概括
免疫检查点抑制剂 (ICI) 心肌炎很罕见,但致命. 通过托波和心电图监测进行早期诊断,然后服用高剂量的类固醇,可以改善非小细胞肺癌患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 可以引起心肌炎,这是一个严重的不良事件.
- 这项研究侧重于非小细胞肺癌 (NSCLC) 患者的ICI相关心肌炎.
研究的目的:
- 综合描述ICI相关心肌炎的临床特征,诊断和管理.
- 确定早期检测和有效治疗策略的关键指标.
主要方法:
- 对14例ICI相关心肌炎病例和45例NSCLC患者的对照进行了回顾性分析.
- 详细的实验室测试,成像和临床数据收集,包括救援和随访.
- 对并发不良事件,心脏生物标志物和心电图 (ECG) 发现的分析.
主要成果:
- 心肌炎发生在ICI启动后的中位数为34天.
- 同时发生的肌肉炎和外围神经炎是常见的 (P<0.001).
- 在92%的病例中心脏托罗邦素I (cTnI) 升高,所有病例中心电图异常.
- 类固醇治疗在76.9%的患者中有效,死亡率为7.1%.
- 高剂量葡萄糖皮质类药物与免疫球蛋白在严重病例中显示出有效性.
结论:
- 早期诊断ICI相关心肌炎至关重要,cTnI和ECG是敏感的指标.
- 高剂量的皮质糖类药物对缓解和稳定症状是有效的,特别是在急性病例中.
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