曲妥珠单抗单药治疗乳腺癌致左心室功能不全一例  

Left ventricular dysfunction induced by trastuzumab treatment of breast cancer: a case report

作　　者：刘婧[1] 巩会平[1] 盛林[1] 王永梅[1] 鹿庆华[1] 

机构地区：[1]山东大学第二医院,济南250033

出　　处：《新医学》2017年第1期60-62,共3页Journal of New Medicine

基　　金：山东省自然科学基金(ZR2013HQ065)

摘　　要：曲妥珠单抗是针对Her2阳性乳腺癌的分子靶向药物,该文报道1例在单用曲妥珠单抗(每3周1次)方案治疗后出现左心室功能不全的右乳腺癌患者。该患者应用曲妥珠单抗第2次后逐渐出现憋气,平卧位明显,伴咳嗽、腹胀、双下肢水肿,心内科住院经心脏彩超、正电子发射断层显像/X线计算机体层成像检查,诊断为左心室功能不全。患者应用曲妥珠单抗治疗前LVEF为0.66,应用曲妥珠单抗后LVEF最低至0.29,且既往无高血压、糖尿病、冠心病史,故考虑其左心室功能不全可能与使用曲妥珠单抗有关,停药后对症处理40 d左心室功能恢复正常。该例提示应规范用药,按说明书严密监测不良反应,避免不良后果。Trastuzumab is a molecular targeted drug for Her2-positive breast cancer patients. In this paper, we reported one case of right breast cancer presenting with left ventricular dysfunction after single use of trastuzumab once every 3 weeks. After the second time of use of trastuzumab, she gradually developed breath-lessness which aggravated in a supine position, accompanied with cough, abdominal distension and bilateral lower extremity edema. During hospitalization in the Department of Cardiology, she was diagnosed with left ventricular dysfunction by echocardiography and PET/CT. Before the treatment of trastuzumab, the left ventric-ular ejection fraction （LVEF） of the patient was 0.66 which decreased to 0. 29 after usage of trastuzumab. She reported no medical history of hypertension, diabetes mellitus and coronary heart disease. Hence, the inci-dence of left ventricular dysfunction was probably correlated with the use of trastuzumab. Left ventricular dys-function was recovered after trastuzumab withdrawal and 40-day symptomatic treatment. The diagnosis and treatment of this case hinted that standard use of medication should be implemented. Adverse events should be intimately monitored according to the manufacturers’instructions to avert the incidence of severe consequences.

关 键 词：曲妥珠单抗 乳腺癌 左心室功能不全 

分 类 号：R737.9[医药卫生—肿瘤]