注射用卡瑞利珠单抗致免疫相关性心肌炎的文献病例分析  

Literature Case Analysis of Immune-Related Myocarditis Induced by Camrelizumab for Injection

作　　者：孙晓利[1] 白万军[2] 刘红[1] 冯晓杰[1] 王紫月 梁平[1] 冯锐[1] 霍丽曼 SUN Xiaoli;BAI Wanjun;LIU Hong;FENG Xiaojie;WANG Ziyue;LIANG Ping;FENG Rui;HUO Liman(Dept.of Pharmacy,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Dept.of Pharmacy,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第四医院药学部,石家庄050011 [2]河北省人民医院药学部,石家庄050051

出　　处：《中国医院用药评价与分析》2024年第9期1149-1152,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2022年度河北省医学科学研究重点课题计划项目(No.20221338)。

摘　　要：目的:了解注射用卡瑞利珠单抗致免疫相关性心肌炎的临床特点、治疗与转归,促进临床安全用药。方法:收集建库至2024年7月Wiley Online Library、Embase、PubMed、中国生物医学文献数据库、万方数据库、中国知网、维普数据库等数据库中收录的注射用卡瑞利珠单抗致免疫相关性心肌炎的病例报道文献。对纳入文献中患者的基本信息、用药方案及联合用药、合并症、心肌炎发生时间、转归与干预等进行统计分析。结果:共纳入25篇文献,涉及26例患者,其中男性患者14例,女性患者12例;年龄分布于45~79岁,平均年龄为64.7岁;临床诊断以肺癌为主,共9例;记录有既往病史的有9例,其中糖尿病史3例;记录有联合用药情况的有21例;11例患者发生心肌炎的时间为注射用卡瑞利珠单抗第1个周期用药后,最早为首次用药后2 d;最常见的临床表现包括胸闷、乏力、呼吸困难、肌肉无力或酸痛等,15例患者同时合并其他免疫相关不良反应;19例患者好转,3例未好转,4例死亡。出现心肌炎时,所有患者均及时给予了糖皮质激素,2例植入了永久心脏起搏器。结论:临床在使用注射用卡瑞利珠单抗时,应做好常规监测和心脏功能相关基线检查,治疗期间应密切观察,一旦出现心肌炎症状,要尽早采取干预措施,保证患者用药安全。OBJECTIVE:To investigate the clinical characteristics,treatment and outcome of immune-related myocarditis induced by carrilizumab for injection,so as to promote the safe application in clinic.METHODS:Wiley Online Library,Embase,PubMed,CBM,Wanfang Data,CNKI,VIP databases were retrieved to collect case report literature of immune-related myocarditis induced by carrilizumab for injection.The retrieval time was from the establishment of the database to Jul.2024.Statistical analysis was performed on basic information,medication regimen and drug combination,complication,onset time of myocarditis,outcome and intervention in the included literature.RESULTS:A total of 25 articles were enrolled,including 26 patients,with 14 males and 12 females.The age distribution was from 45 to 79 years,with a mean age of 64.7 years.The clinical diagnosis was mainly lung cancer in 9 cases;9 patients had previous medical history,3 of which had a history of diabetes.There were 21 cases with drug combination.The onset of myocarditis in 11 patients was after the first administration cycle of carrilizumab for injection,and the earliest was 2 d after the first administration.The most common clinical manifestations included chest tightness,fatigue,dyspnea,muscle weakness or soreness,and 15 patients were combined with other immune-related adverse drug reactions.19 patients were improved,3 patients did not improve,and 4 patients died.When myocarditis developed,all patients were promptly given glucocorticoids,and two had a permanent pacemaker implanted.CONCLUSIONS:It is suggested that baseline examination and routine monitoring of cardiac function should be done well when patients are treated with camrelizumab for injection.Close observation should be made during treatment,once the patient is suspected to have immune-related myocarditis,early intervention should be taken to ensure the medication safety.

关 键 词：注射用卡瑞利珠单抗 不良反应 免疫相关性心肌炎 

分 类 号：R969.3[医药卫生—药理学] R979.1[医药卫生—药学]