免疫检查点抑制剂相关毒副作用管理之激素的使用  

The Use of Glucocorticoid in the Management of Adverse Effects Related to Immunocheckpoint Inhibitors

作　　者：王汉萍[1] 周佳鑫[2] 郭潇潇[3] 李玥[4] 段炼[5] 斯晓燕[1] 张力[1] Hanping WANG;Jiaxin ZHOU;Xiaoxiao GUO;Yue LI;Lian DUAN;Xiaoyan SI;Li ZHANG(Department of Respirology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Rheumatology and Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Cardiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医院呼吸内科,北京100730 [2]中国医学科学院,北京协和医院风湿免疫科,北京100730 [3]中国医学科学院,北京协和医院心内科,北京100730 [4]中国医学科学院,北京协和医院消化内科,北京100730 [5]中国医学科学院,北京协和医院内分泌科,北京100730

出　　处：《中国肺癌杂志》2019年第10期615-620,共6页Chinese Journal of Lung Cancer

基　　金：中国医学科学院医学与健康科技创新工程资助项目（No.2016-I2M-1-002）资助~~

摘　　要：免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)通过激活机体的肿瘤免疫杀灭肿瘤细胞,给肿瘤患者的治疗带来新的希望。然而也可引起一系列以免疫损伤为基础的免疫检查点抑制剂相关毒副反应(immune-related adverse events,irAEs).糖皮质激素是治疗这类毒副反应的基础,而在具体治疗irAEs时,其用法、用量、疗程又与治疗经典的自身免疫性疾病有所不同。同时,大剂量的糖皮质激素的长期使用可能引起严重的不良反应,本文对激素的作用机制、剂量剂型、毒副作用及管理等方面进行详细描述,为肿瘤医生在临床实践中应用激素提供参考和建议。Immunocheckpoint inhibitors(ICIs)activated the patients'tumor immunity to kill the tumor cell,and brought new hope to patients with tumor.However,a series of immunocheckpoint inhibitors related adverse effects(irAEs)may also occur based on immune injury.Glucocorticoids are the basis for the treatment of such irAEs.However,the usage,dosage and course of treatment of glucocorticoid in irAEs are different from those in classic autoimmune diseases.Meanwhile,long-term use of large doses of glucocorticoids may cause serious adverse effects too.In this paper,the mechanism,dosage forms,adverse effects and management of glucocorticoids are described in detail,providing references and suggestions for oncologists to apply glucocorticoids in clinical practice.

关 键 词：免疫检查点抑制剂 免疫相关不良反应 糖皮质激素 免疫抑制 

分 类 号：R73[医药卫生—肿瘤]