13例PD-1抑制剂致免疫性肺炎病例分析  

13 cases of immune-related pneumonia induced by PD-1 inhibitor

作　　者：程晟[1] 温爱萍[1] 董怡文 余俊先[1] 李哲[1] 李新刚 CHENG Sheng;WEN Ai-ping;DONG Yi-wen;YU Jun-xian;LI Zhe;LI Xin-gang(Department of Pharmacy,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050)

机构地区：[1]首都医科大学附属北京友谊医院药学部,北京100050

出　　处：《中南药学》2023年第10期2809-2812,共4页Central South Pharmacy

基　　金：2022白求恩·求索-药学科研能力建设项目(No.23);国家自然科学基金青年项目(No.82203039)。

摘　　要：目的分析PD-1抑制剂相关免疫性肺炎的临床特点,为临床安全用药提供参考。方法回顾性分析首都医科大学附属北京友谊医院2019年1月1日—2022年12月31日共13例PD-1抑制剂致免疫性肺炎病例的诊疗过程及临床特点。结果13例患者中男11例,女2例;使用药物包括卡瑞利珠单抗6例,纳武利尤单抗3例,替雷利珠单抗2例,信迪利单抗2例。用药开始至确诊平均为(5.15±2.80)个治疗周期。患者症状主诉为喘憋6例(46.15%);咳嗽及咳痰的3例(23.08%);没有明显主观症状的5例(38.46%)。胸部CT检查结果以双肺多发磨玻璃影为主,共12例(92.31%)。13例患者予糖皮质激素治疗,平均疗程为(27.38±16.46)d。经治疗所有患者临床症状均明显好转。复查胸部CT仅1名患者痊愈。结论免疫性肺炎是PD-1抑制剂发生率较低的严重不良反应,临床药师应积极参与评估和处置,保证患者的用药安全。Objective To analyze the clinical characteristics of immune-related pneumonia associated with PD-1 inhibitors,and provide reference for clinical safe drug use.Methods The diagnosis and treatment of 13 cases of immune-related pneumonia induced by PD-1 inhibitors in Beijing Friendship Hospital affiliated to Capital Medical University from Jan 1st 2019 to Dec 31st 2022 were analyzed retrospectively.The clinical characteristics and pharmaceutical care were analyzed.Results There were 11 males and 2 females.The medications included 6 of camrelizumab,3 of nivolumab,2 of tirelizumab,and 2 of sintilimab.The average period from the beginning of medication to the diagnosis was(5.15±2.80).The main complaints of the patients included 6 cases of dyspnea(46.15%),and 3 of cough and expectoration(23.08%).There were 5(38.46%)without obvious subjective symptoms.Chest CT scan mainly showed multiple ground glass shadows in both lungs in 12(92.31%).Totally 13 patients given glucocorticoid,and the average course of treatment was(27.38±16.46)d.After the treatment,the clinical symptoms of all patients were improved obviously.Only one patient recovered.Conclusion Immune-related pneumonia is a serious adverse reaction with low incidence of PD-1 inhibitor.Clinical pharmacists should pay attention to the evaluation and management of safe of drug use.

关 键 词：PD-1抑制剂 免疫检查点抑制剂 免疫性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]