免疫检查点抑制剂相关性糖尿病2例临床分析  

Clinical analysis of 2 cases of immune checkpoint inhibitor-related diabetes mellitus

作　　者：杨芳[1] 朱新新 王敏 晏益民[2] YANG Fang;ZHU Xinxin;WANG Min;YAN Yimin(Teaching and Research Section of Internal Medicine,Medical College,Wuhan University of Science and Technology,Wuhan 430000,China;Department of Endocrinology,Central Hospital of Xiaogan,Hubei Xiaogan 432000,China)

机构地区：[1]武汉科技大学医学院内科教研室,武汉430000 [2]湖北省孝感市中心医院内分泌科,湖北孝感432000

出　　处：《药学服务与研究》2021年第2期106-109,共4页Pharmaceutical Care and Research

摘　　要：目的:探讨因使用免疫检查点抑制剂(immune checkpoint inhibitors,ICPis)导致ICPis相关性糖尿病患者的临床特点。方法:回顾2例确诊为ICPis相关性糖尿病患者的临床资料,并复习相关文献。结果:2例ICPis相关性糖尿病患者均有肿瘤病史并接受ICPis治疗,且ICPis治疗前无糖尿病病史。文献报道患者多在使用ICPis治疗后12周,也有在几个月到几年后出现血糖升高。ICPis相关性糖尿病病情进展快,特别在联用细胞毒性T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)抗体与程序性死亡受体1(programmed death 1,PD-1)抗体后,病情进展更快。若不及时治疗易发生糖尿病酮症酸中毒。结论:ICPis相关性糖尿病是ICPis罕见但严重的副作用。建议接受ICPis治疗的患者定期监测血糖,尽早筛查可能出现的ICPis相关性糖尿病,及时治疗,改善预后。Objective:To investigate the clinical characteristics of the patients with immune checkpoint inhibitor(ICPis)-related diabetes mellitus.Methods:The clinical data of the 2 patients confirmed to have ICPis-related diabetes mellitus were retrospectively analyzed and related literature was reviewed in the process.Results:The 2 patients with ICPis-related diabetes mellitus all had a history of tumor and received ICPis treatment,but without a medical history of diabetes mellitus before ICPis treatment.Literature reports indicated that most of the patients had hyperglycemia after 12 weeks of ICPis treatment,and rare cases of hyperglycemia were seen after several months or even years after ICPis treatment.The progress of ICPis-related diabetes mellitus was generally fast,and this was especially the case when it was used with cytotoxic T lymphocyte-associated antigen 4(CTLA-4)antibody and programmed death 1(PD-1)antibody.Patients would be more susceptible to diabetic ketoacidosis without prompt treatment.Conclusion:ICPis-related diabetes mellitus is a rare but serious side effect of ICPis.It is suggested that patients receiving ICPis treatment should have regular blood glucose detection,so that ICPis-related diabetes mellitus could be screened at an early stage,and early treatment could be received and prognosis could be improved.

关 键 词：免疫检查点抑制剂相关性糖尿病 药物副反应报告系统 细胞毒性T淋巴细胞相关抗原4 程序性死亡受体1 

分 类 号：R979.1[医药卫生—药品] R977.15[医药卫生—药学]