信迪利单抗致多器官免疫不良反应病例分析
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i3.14464
Abstract
探讨免疫检查点抑制剂诱发免疫相关不良事件的临床特征和干预措施,提升临床对药物相互作用的认识。结合文献,对1例67岁女性原发性宫颈鳞癌患者在选择同步放化疗联合信迪利单抗免疫治疗2个周期后出现颈部、背部疼痛,出现双侧上眼睑下垂。考虑为信迪利单抗所致免疫相关性肌炎、免疫相关性肌痛、免疫相关性肝炎、免疫相关性重症肌无力、免疫相关性心肌炎。立即停止放化疗,但本患者及家属担忧糖皮质激素引发感染风险及长期后遗症,多次沟通均拒绝使用。这也提示当前知情同意流程存在优化空间。虽然后期患者出院后相关症状逐渐缓解,实验室指标也逐渐趋于正常,但对原发疾病宫颈鳞癌的治疗已经延误。未来需建立免疫治疗不良反应的标准化优化沟通路径,包括治疗前预设方案、决策节点多学科评估,以平衡患者自主权与医疗行善原则。
Keywords
信迪利单抗；免疫检查点抑制剂；免疫相关性肝炎；免疫相关性肌痛；免疫相关性心脏炎
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