2025 年第 1 期 第 20 卷

替雷利珠单抗致非心肌炎性的左心室功能损害1例

A case of left ventricular dysfunction without myocardial inflammation caused by tislelizumab

作者：饶敏  童皖宁

英文作者：Rao Min Tong Wanning

单位：中国人民解放军海军特色医学中心呼吸与危重症医学科，上海200052

英文单位：Department of Respiratory and Critical Care Medicine Naval Medical Center of the Chinese People′s Liberation Army Shanghai 200052 China

关键词：替雷利珠单抗；  非心肌炎性的左心室功能损害；  免疫相关不良事件

英文关键词：Tirelizumab;  Leftventriculardysfunctionwithoutmyocardialinflammation;  Immune-relatedadverseevents

• 摘要：

• 1例59岁女性晚期肺腺癌患者，在使用替雷利珠单抗200 mg免疫治疗1个周期后，出现急性左心功能衰竭表现，B型脑钠肽明显升高，心肌酶谱持续正常，分析原因可能为免疫相关性的非心肌炎性的左心室功能损害，积极给予激素治疗后，患者心力衰竭症状明显缓解，但左心室功能损害无法逆转。因此，对于肿瘤患者免疫治疗后出现的左心室功能损害，尽管心肌酶谱持续正常，仍应考虑到免疫相关性的非心肌炎性的左心室功能损害，需使用激素治疗，且该左心室功能损害无法逆转。

• A 59-year-old female patient with advanced lung adenocarcinoma developed acute left heart failure after one cycle of immunotherapy with tislelizumab 200 mg. The brain natriuretic peptide was significantly increased, and the myocardial enzyme spectrum remained normal. The cause may be immune-related non-myocardial inflammatory left ventricular dysfunction. After active glucocorticoid therapy, the patient′s symptoms of heart failure were significantly relieved, but left ventricular dysfunction could not be reversed. Therefore, for patients with tumor immunotherapy of left ventricular function after injury, while myocardial enzyme spectrum continue to normal, still should take into account the immune correlation of the left ventricular function of myocardial inflammatory damage, need to use hormone therapy, and the left ventricular function damage is irreversible.