目的 探索帕博利珠單抗致甲狀腺功能障礙發(fā)生的規(guī)律和臨床特點(diǎn)，為臨床安全用藥提供參考。方法 檢索知網(wǎng)、維普、萬(wàn)方、PubMed、Web of Science數(shù)據(jù)庫(kù)，收集關(guān)于帕博利珠單抗致免疫性皮膚病的文獻(xiàn)數(shù)據(jù)并進(jìn)行統(tǒng)計(jì)分析。結(jié)果 納入16篇文獻(xiàn)，共16例甲狀腺功能障礙病例，年齡為30～77歲；甲狀腺功能障礙發(fā)生時(shí)間最早為給藥后14 d，最晚為給藥后240 d；常規(guī)給予左甲狀腺素治療甲狀腺功能減退及給予甲硫咪唑治療甲狀腺功能亢進(jìn)，經(jīng)過(guò)治療后多數(shù)患者甲狀腺功能障礙好轉(zhuǎn)。結(jié)論 在使用帕博利珠單抗時(shí)要注意監(jiān)測(cè)甲狀腺功能障礙不良反應(yīng)，一旦發(fā)生應(yīng)及時(shí)進(jìn)行相應(yīng)治療。

Objective To explore the regularity and clinical characteristics of thyroid dysfunction caused by pembrolizumab, so as to provide reference for clinical application. Methods Literatures of thyroid dysfunction induced by pembrolizumab were collected and statistically analyzed by searching CNKI, VIP database, Wanfang database, PubMed, and Web of Science. Results Totally, 16 patients with thyroid dysfunction caused by pembrolizumab were included, the range of age was 30 — 77 years. The earliest time of occurrence of thyroid dysfunction was 14 d after administration, and the lastest was 240 d after administration. Levothyroxine was routinely given to treat hypothyroidism and methiimidazole was given to treat hyperthyroidism. After treatment, the patients with thyroid dysfunction caused by pembrolizumab were improved. Conclusion When using pembrolizumab, we should pay attention to the monitoring of thyroid dysfunction adverse reactions, and take timely treatment once the adverse reactions occur.

R979.1

吳階平醫(yī)學(xué)基金會(huì)臨床科研專項(xiàng)資助基金項(xiàng)目（320.6750.2020-11-26）