安罗替尼致心力衰竭

Heart failure due to anlotinib

1例66岁女性左肺浸润性腺癌患者接受安罗替尼12 mg口服、1次/d,服用2周,停用1周,3周为1个周期。规律用药14个月后患者出现心慌、胸闷,实验室检查示氨基末端脑利钠肽前体(NT-proBNP)1698 ng/L,超声心动图示心尖运动减弱,左心室舒张功能不全,考虑为心力衰竭,怀疑与安罗替尼有关,停用该药并予对症治疗。8 d后患者上述症状减轻,NT-proBNP 485 ng/L。因病情需要,患者遵医嘱再次按原剂量口服安罗替尼。3个月后上述症状复现,并突发心室颤动,考虑患者的心力衰竭为安罗替尼所致。再次停用安罗替尼,给予利尿、改善心功能、营养心肌、补钾等治疗11 d后,病情明显好转。此后患者未再服用安罗替尼。

A 66⁃year⁃old female patient with infiltrating adenocarcinoma in left lung received anlotinib 12 mg orally once daily(2⁃week medication followed by 1⁃week discontinuation,3 weeks was a cycle).After 14 months of regular medication,the patient developed palpitation and chest tightness.Labora⁃tory tests showed that the N⁃Terminal pro⁃brain natriuretic peptid(NT⁃proBNP)was 1698 ng/L;echocardiog⁃raphy showed decreased apical wall motion and left ventricular diastolic dysfunction.Heart failure was cond⁃sidered,which was suspected to be related to anlotinib.Anlotinib was stopped and symptomatic treatments were given.Eight days later,her symptoms above⁃mentioned were alleviated and NT⁃proBNP was 485 ng/L.Because of the illness condition,the patient took anlotinib again at original dose according to the doctor′s instructions.Three months later,the above symptoms recurred and ventricular fibrillation occurred suddenly.Considering that the heart failure in the patient might be caused by anlotinib.Anlotinib was stopped again.After 11 days of treatments with diuretics,cardiac function improvement,myocardial nutrition,and potassium supplement,the patient′s condition was improved obviously.After that,the patient did not take anlotinib again.