帕博利珠单抗致免疫介导性肝损伤的文献回顾性分析  

Pembrolizumab-Induced Immune-Mediated Liver Injury:a Retrospective Study and Review of the Literature

作　　者：狄潘潘 贾淑云 梁海[1] 王杰 胡云飞 Di Panpan;Jia Shuyun;Liang Hai;Wang Jie;Hu Yunfei(Department of pharmacy,the Affi liated Bozhou Hospital of Anhui Medical University,Bozhou 236800,China;School of Public Basic,Bengbu Medical College,Bengbu 233030,China;Bozhou University,Bozhou 236800,China)

机构地区：[1]安徽医科大学附属亳州医院药学部,亳州236800 [2]蚌埠医学院公共基础学院,蚌埠233030 [3]亳州学院,亳州236800

出　　处：《中国药事》2024年第1期111-117,共7页Chinese Pharmaceutical Affairs

基　　金：安徽医科大学校基金资助项目(编号2021xkj095);亳州市人民医院院级科研项目(编号by2023006)。

摘　　要：目的:回顾性分析帕博利珠单抗致肝损伤的临床特点与危险因素,为临床安全用药提供参考。方法:检索中国知网、万方医学网、维普网、中国生物医学文献网、PubMed、Science Direct、Wiley及Springer等数据库中收录的关于帕博利珠单抗致肝炎的病例报告进行归纳与分析。结果:帕博利珠单抗致肝损伤的病例报告共28例,以男性(57.1%)患者居多,年龄以51~70岁(60.7%)为主,发生时间多在用药后30 d内(57.2%)。肝损伤类型以胆汁淤积型多见,损伤程度多为3~4级。大多数患者(78.6%)经停药和治疗后肝损伤好转或痊愈。结论:临床医师在应用帕博利珠单抗过程中应密切监测患者肝功能,避免严重肝损伤的发生,确保临床安全用药。Objective:To retrospectively analyze the clinical characteristics and risk factors of liver injury caused by pembrolizumab,so as to provide reference for clinical safe drug use.Methods:Case reports of hepatitis caused by pembrolizumab in China National Knowledge Infrastructure(CNKI),Wanfang Medical Network,VIP,China BioMedical Literature Network,PubMed,Science Direct,Wiley,Springer and other databases were searched for induction and analysis.Results:A total of 28 cases of liver injury caused by pembrolizumab were reported,most of them were males(57.1%),aged 51~70 years(60.7%),and most of them occurred within 30 days after treatment(57.2%).Cholestasis was the most common type of liver injury,and the degree of injury was grade mostly grade 3~4.Most patients(78.6%)improved or recovered after drug withdrawal and treatment.Conclusion:During the application of pembrolizumab,clinicians should closely monitor the patient's liver function to avoid serious liver injury and ensure the clinical safety of drug use.

关 键 词：帕博利珠单抗 肝损伤 不良反应 病例分析 免疫检查点抑制剂 

分 类 号：R969.3[医药卫生—药理学]