帕博利珠单抗致免疫介导性肝损伤的文献回顾性分析

目的：回顾性分析帕博利珠单抗致肝损伤的临床特点与危险因素，为临床安全用药提供参考。方法：检索中国知网、万方医学网、维普网、中国生物医学文献网、PubMed、Science Direct、Wiley及Springer等数据库中收录的关于帕博利珠单抗致肝炎的病例报告进行归纳与分析。结果：帕博利珠单抗致肝损伤的病例报告共28例，以男性（57.1%）患者居多，年龄以51～70岁（60.7%）为主，发生时间多在用药后30 d内（57.2%）。肝损伤类型以胆汁淤积型多见，损伤程度多为3～4级。大多数患者（78.6%）经停药和治疗后肝损伤好转或痊愈。结论：临床医师在应用帕博利珠单抗过程中应密切监测患者肝功能，避免严重肝损伤的发生，确保临床安全用药。

Pembrolizumab-Induced Immune-Mediated Liver Injury: a Retrospective Studyand Review of the Literature

Objective: To retrospectively analyze the clinical characteristics and risk factors of liver injury causedby pembrolizumab, so as to provide reference for clinical safe drug use. Methods: Case reports of hepatitis causedby pembrolizumab in China National Knowledge Infrastructure (CNKI), Wanfang Medical Network, VIP, ChinaBioMedical Literature Network, PubMed, Science Direct, Wiley, Springer and other databases were searchedfor induction and analysis. Results: A total of 28 cases of liver injury caused by pembrolizumab were reported,most of them were males (57.1%) , aged 51~70 years (60.7%), and most of them occurred within 30 days aftertreatment (57.2%). Cholestasis was the most common type of liver injury , and the degree of injury was grademostly grade 3~4. Most patients (78.6%) improved or recovered after drug withdrawal and treatment. Conclusion:During the application of pembrolizumab, clinicians should closely monitor the patient''s liver function to avoidserious liver injury and ensure the clinical safety of drug use.