免疫检查点抑制剂相关风湿免疫病表现及管理  

Clinical manifestations and management of immune checkpoint inhibitors associated rheumatic disease

作　　者：樊勇[1] 耿研[1] 赵娟[1] 张卓莉[1] Fan Yong;Geng Yan;Zhao Juan;Zhang Zhuoli(Department of Rheumatology and Clinical Immunology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院风湿免疫科,北京100034

出　　处：《中国医学前沿杂志（电子版）》2022年第8期6-10,I0002,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：中央高水平医院临床科研业务费资助(北京大学第一医学院科研“希望之星”专项,2022XW05);国家自然科学基金青年科学基金项目(82000060)。

摘　　要：免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)是近些年肿瘤治疗领域里程碑式突破,但由于其亦可引发正常组织/器官的非特异性免疫反应增强,从而导致免疫相关不良反应(immune-related adverse events,ir AEs)。ir AEs与风湿免疫病发病机制相似,因此可模拟大部分的风湿免疫病,如关节炎、风湿性多肌痛、肌炎、干燥综合征、血管炎等。早期诊断、及时干预这类ir AEs对于改善恶性肿瘤患者生活质量和预后至关重要。因此,本文就ICIs使用过程中所致风湿免疫性ir AEs的表现及特点、诊断及鉴别诊断、治疗管理加以综述,以期借此加强临床医师对这类ir AEs的认识及处理。Immune checkpoint inhibitors(ICIs)have revolutionized the treatment of advanced cancers in recent decades.Due to non-specific immune activation in off-target organs,ICIs usually cause immune-related adverse events(ir AEs).Ir AEs have shared similar pathogenesis with many rheumatic diseases,therefore ir AEs can simulate almost all rheumatic diseases and manifest as inflammatory arthritis,polymyalgia rheumatica,myositis,Sj?gren syndrome,vasculitis etc.Early diagnosis and appropriate treatment of ir AEs will improve outcomes and quality of life for cancer patients.In this review,we summarize advanced literatures and findings about ICIs associated rheumatic ir AEs,focusing mainly on the clinical manifestations,diagnosis and differential diagnosis,and strengthen the understanding of ir AEs for clinicians.

关 键 词：免疫检查点抑制剂 免疫相关不良反应 风湿免疫病 

分 类 号：R593.2[医药卫生—内科学]