| 罗琪,陈泳伍.纳武利尤单抗致免疫相关性肝炎文献回顾性分析[J].安徽医药,2020,24(10):2116-2120. |
| 纳武利尤单抗致免疫相关性肝炎文献回顾性分析 |
| Literature retrospective analysis of immune?related hepatitis induced by Nivolumab since post?marketing |
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| DOI：10.3969/j.issn.1009?6469.2020.10.050 |
| 中文关键词: 免疫疗法 纳武利尤单抗 免疫相关性肝炎 程序性细胞死亡受体 1 回顾性研究 |
| 英文关键词: Immunotherapy Nivolumab Immune?related hepatitis Programmed cell death 1 receptor Retrospective studies |
| 基金项目: |
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| 摘要点击次数: 1552 |
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| 中文摘要: |
| 目的探讨纳武利尤单抗致免疫相关性肝炎毒性反应的临床特点，旨在为临床上合理应用纳武利尤单抗提供参考。方法检索中国知网、维普、万方、 PubMed以及 Web of Science数据库，收集 2015年 3月至 2019年 8月关于纳武利尤单抗致免疫相关性肝炎的文献，提取数据并整理分析。结果纳入分析的病人共 15例，其中男性 13例，女性 2例；年龄范围为 14～80岁，其中 31～60岁年龄段较多(10例， 66.7％)；原发疾病为恶性黑色素瘤 7例，非小细胞肺癌 4例，肝癌 2例，胃腺癌 1例，霍奇金淋巴瘤 1例；单用纳武利尤单抗者 8例，联合应用纳武利尤单抗和伊匹单抗者 7例； ADR发生时间最短为用药后 1周，最长为用药后 40周，多发生在用药后的 90d内(8例， 53.3%)； 15例 ADRs报道中，以肝酶升高为主(11例， 73.3%)，其中肝酶升高伴胆红素升高 5例。经停药和(或)对症治疗后， 4例好转， 7例死亡。结论临床医师和药师应了解纳武利尤单抗致免疫相关性肝炎的规律和特点，加强用药监测，重视其不良反应的发生，做到及时处理及对症治疗。 |
| 英文摘要: |
| Objective To explore the clinical characteristics of immune?related hepatitis induced by nivolumab，and to provide ref? erence for the rational application of nivolumab in clinic.Method CNKI，VIP，Wanfang，PubMed and Web of Science databases were searched for immune?related hepatitis induced by Nivolumab，and collected literatures from March 2015 to August 2019 were further analyzed statistically.Results A total of 15 patients enrolled in the study，including 13 males and 2 females，aged 14?80 years，of them，patients of 31 to 60 years showedthe highestincidence(n＝10，66.7%).Primary diseases of the patients included ma? lignant melanoma(7 patients)，non small?cell lung cancer(4 patients)，liver cancer(2 patients)，gastric adenocarcinoma(1 patients)， and hodgkin lymphoma(1 patients).Of the 15 patients，8 patients received nivolumab monotherapy，7 patients received combination therapy with nivolumab and ipilimumab.The occurrence time of adverse drug reactions(ADRs)was the shortest 1 week and the lon? gest 40 weeks after the medication，frequently occurred within 90 days(n＝8，53.3%).15 cases of ADRs were reported，mainly in? cluding elevatedliver enzymes(n＝11，73.3%)，of which 5 cases had elevated liver enzymes and elevated bilirubin.After stopping the drug and/or symptomatic treatment，4 patients were improved and 7 patients died.Conclusion Clinicians and pharmacistsshould understand rules and characteristics of immune?related hepatitis induced by Nivolumab and strengthen monitoring.In the pro?cess of clinical drug use，close attention should be paid to adverse reactions，so that timely treatment and symptomatic treatment can be achieved. |
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