在患有多发性骨髓瘤的患者中,博尔特佐米布诱导的心肌炎
Adriana Domínguez-Linares1, Ana Karen Nieto-Dolores2, Mauricio Garcia-Cardenas3
1National Institute of Neoplastic Diseases, Lima, Peru; School of Medicine, San Martín de Porres University (USMP), Lima, Peru.
JACC. Case reports
|February 24, 2026
概括
多发性骨髓瘤药物伯特佐米布 (Bortezomib) 很少引起心肌炎. 及时识别和治疗导致患者完全康复,强调了对这种罕见副作用的早期干预的重要性.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 博尔特佐米布是一种蛋白酶体抑制剂,用于多发性骨髓瘤和地幔细胞淋巴瘤.
- 虽然Bortezomib有效,但很少引起心脏毒性,特别是心肌炎.
研究的目的:
- 在多发性骨髓瘤患者中报告一种罕见的博特佐米布诱导心肌炎病例.
- 强调早期诊断和管理的重要性,以获得有利的结果.
主要方法:
- 一个案例研究,一个58岁的男性患有多发性骨髓瘤,在博特佐米布治疗后出现心力衰竭症状.
- 诊断评估包括心声回声学,I型托波水平,冠状动脉CT血管学和心脏MRI.
- 治疗包括停止服用博尔特佐米布,并开始以指导方针为导向的心力衰竭治疗.
主要成果:
- 这位患者出现了严重的左心室缩功能障碍和升的托罗邦素I.
- 心脏MRI证实了急性心肌炎,排除了缺血性原因.
- 停用博特佐米布和心力衰竭治疗导致在3周内完全恢复临床和心声图.
结论:
- 博尔特佐米布诱导的心肌炎是一种非常罕见但严重的不良事件.
- 潜在的机制包括蛋白酶体抑制,导致细胞应激通路.
- 早期检测,药物戒断和及时的心力衰竭管理对于患者的康复至关重要.
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