斯鲁利单抗注射液致间质性肺炎不良反应1例分析

One case of interstitial pneumonia caused by serplulimab injection

目的 分析斯鲁利单抗注射液致肺损伤发生率及相关风险因素,为临床用药提供参考。方法 对1例斯鲁利单抗注射液致间质性肺炎不良反应患者的临床资料进行分析,并对国内外文献进行回顾总结。结果 本例患者使用注射用奈达铂及依托泊苷注射液联合斯鲁利单抗注射液进行化疗,在联合化疗第2个疗程(即总第3个化疗疗程)出现间质性肺炎不良反应,经关联性分析判断为斯鲁利单抗注射液所致。文献分析显示斯鲁利单抗注射液致肺损伤不良反应的发生率为1.6%~8.2%,相关风险因素主要有吸烟史、烟草暴露史、患者的体能状态不良、年龄、肺部基础疾病及肺部放疗史等,推荐用于65岁以下患者。结论 临床应注意斯鲁利单抗注射液间质性肺炎风险,用药前充分评估患者的潜在风险因素,尽早预防,用药期间密切关注患者呼吸系统症状,一旦怀疑药物相关性肺损伤应及时复查患者肺部影像学、肺功能及动脉血气等,并评估其严重程度,及时做出处理,以降低患者用药风险。

Objective To analyze the incidence of lung injury caused by serplulimab injection and related risk factors so as to provide data for clinical use.Methods The clinical data of one case of adverse reactions-interstitial pneumonia-caused by serplulimab injection was analyzed while the related literature was reviewed and summarized.Results One patient was treated with chemotherapy using injectable nedaplatin and etoposide injection in combination with serplulimab injection,who developed interstitial pneumonia during the 2nd course of combined chemotherapy(a total of three courses),which was determined to be due to the serplulimab injection by correlation analysis.The incidence of lung injury caused by serplulimab injection ranged from 1.6%to 8.2%according to literature,and the associated risk factors included history of smoking,history of tobacco exposure,poor health status,age,underlying lung disease and history of lung radiotherapy.This injection was recommended for use in patients under 65.Conclusion Clinicians are to be alert to the risk of interstitial pneumonia attributed to serplulimab injection.Prior to medication,thorough assessment of potential risk factors is crucial,and precautions need to be taken.During medication,respiratory symptoms of the patient should be closely monitored.In case of drug-related lung injury,pulmonary imaging,pulmonary function and arterial blood gas of the patient have to be examined before the severity is assessed to ensure quick interventions and safety of the patient.