细胞因子释放综合征的发病机制及诊断分级与处理方案

Progress of cytokine release syndrome

嵌合抗原受体T细胞治疗(CAR-T)作为近年来肿瘤治疗的新方法,在血液肿瘤中取得了令人惊喜的结果。细胞因子释放综合征(CRS)是免疫治疗,尤其是CAR-T治疗的一种最常见不良反应,临床症状多样、发生率高,严重者可造成多器官功能衰竭甚至危及患者生命。CRS的发病机制目前仍不清楚,其发生及严重程度与细胞因子如白细胞介素-6等升高、血管内皮激活相关。及早诊断及治疗CRS具有重要的临床意义。托珠单抗及糖皮质激素是目前控制CRS的主要药物,合适时机应用是控制CRS的关键。

Antigen receptor T cells (CAR-T) has achieved surprising results in tumor therapy especially in hema tological malignant diseases. Cytokine release syndrome (CRS) is one of the most common adverse reactions of CAR-T. The clinical symptoms of CRS are various and the incidence is high. Severe cases can cause multiple organ failure and even endanger the lives of patients. The pathogenesis of CRS is still unclear. The occurrence and severity of CRS are related to the elevation of cytokines such as IL-6. Early diagnosis and management is very important. Tocilizumab and glucocorti coid are used to control CRS at present. It is crucial to use drugs at the appropriate time.