1例替雷利珠单抗致免疫相关性肝炎病例的治疗分析

Analysis of Treatment of Immune-Associated Hepatitis Caused by Tirelizumab in One Case

目的:探索替雷利珠单抗发生免疫相关性肝炎的临床特点,为临床合理、安全使用替雷利珠单抗提供参考。方法:通过1例患者发生免疫相关性肝炎的临床特点,结合国内外文献,总结替雷利珠单抗免疫相关性的一般特点、可能的发生机制、相关危险因素及相应的处理办法。结果:该患者极可能发生替雷利珠单抗导致的急性药物性肝损伤(4级),在立即予以激素冲击治疗后,患者肝功能恢复至正常。结论:临床医生应对替雷利珠单抗发生免疫相关性肝炎的特点予以充分的认识,在诊疗过程中做到密切监测、尽早识别并规范处理。

Objective:To explore the clinical characteristics of tirelizumab in immune-associated hepatitis and provide clinician with reference for the reasonable and safe use of tirelizumab.Methods:Based on the clinical characteristics of immune-associated hepatitis in this case,combined with domestic and foreign literature,the occurrence characteristics,possible mechanisms,risk factors and corresponding treatment measures of immune-associated tirelizumab were summarized.Results:The patient was at high risk of acute drug-induced liver injury(grade 4) caused by tirelizumab,and liver function returned to normal after immediate hormone shock therapy.Conclusion:Clinicians should fully understand the characteristics of immune-associated hepatitis caused by tirelizumab,and do close monitoring,early identification and standardized treatment in the course of diagnosis and treatment.