[1]徐文东,陶静怡,李菁,等.免疫检查点抑制剂相关肾上腺损伤病例分析[J].常州大学学报(自然科学版),2024,36(06):90-97.[doi:10.3969/j.issn.2095-0411.2024.06.011]
　XU Wendong,TAO Jingyi,LI Jing,et al.Case analysis adrenal damage associated with immune checkpoint inhibitors[J].Journal of Changzhou University(Natural Science Edition),2024,36(06):90-97.[doi:10.3969/j.issn.2095-0411.2024.06.011]
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免疫检查点抑制剂相关肾上腺损伤病例分析()
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常州大学学报(自然科学版)[ISSN:2095-0411/CN:32-1822/N]

卷:
第36卷
期数:
2024年06期
页码:
90-97
栏目:
生物医药工程
出版日期:
2024-12-03

文章信息/Info

Title:
Case analysis adrenal damage associated with immune checkpoint inhibitors
文章编号:
2095-0411(2024)06-0090-08
作者:
徐文东1; 陶静怡2; 李菁3; 吴萍3; 房灏3
1.常州市第一人民医院 内分泌代谢科, 江苏 常州 213003; 2.常州大学 药学院, 江苏 常州 213164; 3.常州市第一人民医院 药学部, 江苏 常州 213003
Author(s):
XU Wendong1;  TAO Jingyi2;  LI Jing3;  WU Ping3;  FANG Hao3
(1.Department of Endocrinology and Metabolism,The First People's Hospital of Changzhou, Changzhou 213003, China; 2.School of Pharmacy,Changzhou University,Changzhou 213164, China; 3.Department of Pharmacy, The First People's Hospital of Changzhou, Changzhou 213003, China)
关键词:
免疫检查点抑制剂;  肾上腺皮质功能减退症;  回顾性研究;  免疫相关不良事件
Keywords:
immune checkpoint inhibitors;  adrenocortical insufficiency;  retrospective study;  immune-related adverse events
分类号:
R 586
DOI:
10.3969/j.issn.2095-0411.2024.06.011
文献标志码:
A
摘要:
收集2018年1月至2024年4月常州市第一人民医院收住入院的免疫检查点抑制剂(ICIs)导致的肾上腺皮质功能减退症患者,对其基本情况、肿瘤情况、临床表现、治疗及转归进行描述性统计分析,探讨患者使用ICIs后出现肾上腺皮质功能减退症的临床特征。研究共纳入13例患者,男性11例(84.6%),女性2例(15.4%),中位年龄66岁,从使用ICIs至发生肾上腺皮质功能减退症的中位治疗周期为11个,中位时间为266 d。按美国国立卫生研究院和国家癌症研究所通用不良事件术语标准分级,严重(≥3级)病例占84.6%,13例患者在发生肾上腺皮质功能减退症后均暂停ICIs治疗,1例患者肾上腺皮质功能好转后转用程序性死亡受体-配体1(PD-L1)治疗,肾上腺皮质功能减退症未加重,13例接受糖皮质激素治疗后均病情平稳。综上所述,ICIs所致肾上腺皮质功能减退症多发生于老年患者,临床表现以重症为主,停用ICIs并给予糖皮质激素治疗后大多数患者预后良好,个别患者经权衡利弊后在严密监测下可以更换其他种类ICIs治疗。
Abstract:
A descriptive statistical analysis was conducted on patients with adrenal insufficiency caused by immune checkpoint inhibitors(ICIs)admitted to The First People's Hospital of Changzhou from January 2018 to April 2024. The analysis covered the patients' basic demographics, tumor characteristics, clinical manifestations, treatment, and outcomes to explore the clinical features of adrenal insufficiency in cancer patients using ICIs. A total of 13 patients were included in the study, comprising 11 males(84.6%)and 2 females(15.4%), with a median age of 66 years old. The median treatment cycle before the onset of drenocortical insufficiency was 11, with a median duration of 266 d from the administration of ICIs. According to the Common Terminology Criteria for Adverse Events by the National Cancer Institute, 84.6% of cases were severe(≥Grade 3). 13 patients discontinued ICIs after the occurance of adrenal insufficiency, and the antitumor drug of one patient was switched to PD-L1 therapy without adrenal insufficiency recurrence. 13 patients were treated with glucocorticoids and remained clinically stable. In summary, adrenal insufficiency predominantly occurs in elderly patients, with severe clinical symptoms being most common. The prognosis is generally good following the discontinuation of ICIs and the administration of glucocorticoid therapy. In selected cases, other drugs of ICIs may be safely selected under close monitoring after weighing the benefits and risks.

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备注/Memo

备注/Memo:
收稿日期: 2024-06-16。
作者简介: 徐文东(1993—), 男, 安徽亳州人, 硕士, 住院医师。通信联系人: 房灏(1976—), E-mail: 75040349@qq.com
更新日期/Last Update: 1900-01-01