激素无效性免疫检查点抑制剂相关肺炎的诊疗进展  

Progress in the Diagnosis and Treatment of Steroid-Unre-sponsive Pneumonitis Related to Immune Checkpoint Inhibitors

作　　者：冯湘然 高永凤 蓝孝斐 孙娴雯[1,2] 周俊 赵婧雅[1,2] 包志瑶 项轶 FENG Xiangran;GAO Yongfeng;LAN Xiaofei;SUN Xianwen;ZHOU Jun;ZHAO Jingya;BAO Zhiyao;XIANG Yi(Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Institute of Respiratory Diseases,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Civil Aviation Shanghai Hospital,Gubei Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201103,China)

机构地区：[1]上海交通大学医学院附属瑞金医院,上海200025 [2]上海交通大学医学院呼吸病研究所,上海200025 [3]民航上海医院瑞金古北分院,上海201103

出　　处：《中国肿瘤》2025年第3期244-250,共7页China Cancer

基　　金：国家自然科学基金项目(81672271);上海市呼吸传染病应急防控与诊治重点实验室项目(20dz2261100);上海市重点专科项目(shsiczdzk02202);上海市重大传染病研究基地培育项目(20dz2210500);上海交通大学医学院高水平地方高校创新团队(SSMU-ZDCX20181001)。

摘　　要：免疫检查点抑制剂相关肺炎(immune checkpoint inhibitor-related pneumonitis,CIP)是一种常见的免疫相关不良反应。目前CIP的治疗主要依赖于糖皮质激素,70%~80%的患者可通过常规糖皮质激素治疗得到控制,但激素无效性CIP常常症状严重甚至危及生命。对于激素无效性CIP,尚无标准治疗方案,临床未满足需求较大。全文对激素无效性CIP的诊疗进展和探索性研究进行综述,以期为临床诊疗实践提供循证依据。Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70%~80%of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often severe and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

关 键 词：免疫检查点抑制剂相关肺炎 糖皮质激素 免疫抑制剂 抗纤维化治疗 免疫再挑战 

分 类 号：R734.2[医药卫生—肿瘤]