1例帕博利珠单抗致甲状腺功能减退的病例分析  

Case report and literature analysis of hypothyroidism induced by pembrolizumab

作　　者：谭飞龙 夏洪颖[1] 王重娟 丁莉[1] 游丽娜 周丽 金剑[2] Fei-Long TAN;Hong-Ying XIA;Zhong-Juan WANG;Li DING;Li-Na YOU;Li ZHOU;Jian JIN(Department of Pharmacy,the Affiliated Yan'an Hospital of Kunming Medical University,Kunming 650051,China;Department of Pharmacy,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]昆明医科大学附属延安医院药学部,昆明650051 [2]上海交通大学医学院附属第九人民医院药剂科,上海200011

出　　处：《药物流行病学杂志》2023年第2期227-232,共6页Chinese Journal of Pharmacoepidemiology

基　　金：昆明市卫生科技人才培养“千工程”项目[2021-SW(后备)-08]。

摘　　要：1例56岁女性右肺腺癌患者,在帕博利珠单抗联合化疗治疗4个周期后发生2级甲状腺功能减退,考虑为帕博利珠单抗所致。经与临床充分评估,临床药师建议继续免疫治疗,同时补充左甲状腺素,对患者进行用药教育并根据甲状腺功能调整用药剂量,3个月后患者甲状腺功能恢复正常。本文通过对帕博利珠单抗相关不良反应的文献进行复习,进一步分析帕博利珠单抗所致甲状腺功能减退症的发生机制、危险因素、临床特点及治疗预后,提高帕博利珠单抗临床应用的安全性。A 56-year-old woman with adenocarcinoma of the right lung developed grade 2 hypothyroidism after four cycles of pembrolizumab plus chemotherapy,which was considered to be caused by pembrolizumab.After full clinical evaluation,the immune checkpoint inhibitors was not discontinued,and thyroid hormone was supplemented,patients were educated on medication,the drug dose was adjusted according to the thyroid function,and the thyroid function of the patient returned to normal after three months.In order to improve the safely of the clinical application of pembrolizumab,the mechanism,clinical characteristics,risk factors and prognosis of hypothyroidism induced by pembrolizumab were further analyzed by reviewing the literature of the adverse reactions related to it.

关 键 词：帕博利珠单抗 免疫检查点抑制药 甲状腺功能减退 药品不良反应 

分 类 号：R969[医药卫生—药理学]