免疫检查点抑制剂诱导的甲状腺功能障碍对心脏热宁水平的影响
Yuma Shibutani1, Atsushi Kawanobe1, Shinya Suzuki1
1Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan.
免疫检查点抑制剂 (ICI) 可以导致甲状腺功能障碍,这是常见的免疫相关不良事件. 这种功能障碍可能导致心脏损伤,特别是在高甲状腺刺激激素 (TSH) 水平的甲状腺功能低下症中.
科学领域:
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 与内分泌免疫相关的不良事件 (irAEs) 有关,最常见的是甲状腺功能障碍.
- ICI诱导的甲状腺功能障碍对心血管的影响尚未完全理解.
- 甲状腺激素在心血管健康中起着至关重要的作用.
研究的目的:
- 研究ICI诱导的甲状腺功能障碍与心脏损伤之间的关联.
- 评估ICI治疗的患者的心脏标志物,特别是热血素T.
主要方法:
- 在国家癌症中心东部医院接受ICI治疗的94名患者的回顾性研究 (2017年1月 - 2022年7月).
- 测量甲状腺功能和托罗邦素T水平.
- 分析了甲状腺功能障碍和高水平的托罗邦素T之间的相关性.
主要成果:
- 38%的患者 (36/94) 在ICI治疗后表现出较高的托罗邦素T水平.
- 在44%患有高托罗邦素T水平的患者中,发现了甲状腺上风异常反应 (甲状腺功能低下/甲状腺功能过高).
- 当甲状腺刺激激素 (TSH) 水平较高时,托罗邦尼T水平增加,当TSH>20μIU/mL (P=0.009) 时显著升高.
结论:
- 由ICI诱导的甲状腺功能障碍,特别是高TSH的甲状腺功能低下,可能与托罗邦素T表示的心脏损伤有关.
- 在ICI治疗后,建议密切监测心脏标志物以及甲状腺功能.
- 需要进一步的研究来了解长期的心血管影响.
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