经心肌活检诊断替雷利珠单抗相关暴发性心肌炎一例  

A Case of Tislelizumab-associated Fulminant Myocarditis Diagnosed by Myocardial Biopsy

作　　者：阿依努尔·麦合木提 袁杰[1] 陈锐[2] 吴灵敏[3] 段雪晶[4] 程慧[1] 罗晓亮[3] Ayinuer Maihemuti;YUAN Jie;CHEN Rui;WU Lingmin;DUAN Xuejing;CHENG Hui;LUO Xiaoliang(Heart and Vascular Medicine Diagnosis and Treatment Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Oncology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Cardiology,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Department of Pathology,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]新疆维吾尔自治区人民医院心脏及泛血管医学诊疗中心,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院肿瘤科,乌鲁木齐830001 [3]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京100037 [4]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院病理科,北京100037

出　　处：《中国循环杂志》2025年第3期293-296,共4页Chinese Circulation Journal

摘　　要：免疫检查点抑制剂是近年来肿瘤治疗领域的重要进展,其为患者带来生存获益的同时,对各器官的免疫毒性也成为临床中不可回避的新问题,心脏受累的表现包括心力衰竭、心律失常(心房颤动、房室阻滞、束支阻滞、室性心动过速等)、心肌-心包炎、心肌病和心脏性猝死等。本例患者接受替雷利珠单抗治疗1个月后,新发心肌酶异常升高、心功能受损、房室阻滞,心内膜心肌活检证实为免疫检查点抑制剂相关心肌炎。希望通过本例诊断、治疗及相关文献回顾,提高临床医师对免疫检查点抑制剂相关心肌炎的认识,从而提高免疫检查点抑制剂相关心肌炎的诊治水平。Immune checkpoint inhibitors are effective tumor treatment agents with survival benefits.However,immune toxicity to various organs has become a new challenge in clinical practice.The cardiac involvement can be presented as heart failure,arrhythmia(atrial fibrillation,atrioventricular block,bundle branch block,ventricular tachycardia,etc.),myocardialpericarditis,myocardiopathy,and sudden cardiac death,etc.This patient developed abnormally increased myocardial enzymes,impaired cardiac function,and atrioventricular block after 1-month treatment with tislelizumab.Endomyocardial biopsy examination confirmed the diagnosis of immune checkpoint inhibitor-associated myocarditis.Through the diagnosis,treatment,and review of relevant literatures of this case,we wish to improve the understanding of immune checkpoint inhibitor-associated myocarditis,and therefore improve the diagnosis and treatment of immune checkpoint inhibitor-associated myocarditis for clinicians.

关 键 词：心内膜心肌活检 替雷利珠 暴发性心肌炎 免疫检查点抑制剂相关心肌炎 

分 类 号：R54[医药卫生—心血管疾病]