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替雷利珠单抗致史-约综合征和中毒性表皮坏死松解症的文献分析
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| 篇名： | 替雷利珠单抗致史-约综合征和中毒性表皮坏死松解症的文献分析 |
| TITLE： | Literature analysis of tislelizumab-induced Stevens-Johnson syndrome and toxic epidermal necrolysis |
| 摘要： | 目的 分析替雷利珠单抗致史-约综合征（SJS）、中毒性表皮坏死松解症（TEN）的临床特点，为临床用药安全提供参考。方法检索中国知网、维普网、万方数据、PubMed、ScienceDirect、Embase等数据库，收集替雷利珠单抗致SJS/TEN的个案报道并进行描述性分析。结果共纳入17篇文献，共计17例患者，包括SJS4例、TEN13例。17例患者中，男性10例、女性7例，70～79岁者12例，肿瘤类型以肺癌为主（10例），13例患者联用了化疗药物；SJS/TEN的中位发生时间为26（4，104）d，9例患者为首次给药后发生SJS/TEN；16例患者出现前驱性皮疹症状，主要特征为皮肤剥落等严重皮肤损害，伴黏膜损伤。16例患者经对症治疗后好转，1例患者死亡。结论替雷利珠单抗致SJS/TEN的风险以高龄、男性、肺癌、联合化疗者更高，黏膜损伤、异常皮疹等可能是SJS/TEN发生的早期信号；临床使用时可通过识别高危人群、密切监测首次用药至第5周期内的皮肤症状、加强患者教育等手段进行药学监护；出现相关症状时，应及时停药并进行对症治疗，以保障患者的用药安全。 |
| ABSTRACT： | OBJECTIVE To analyze the clinical characteristics of Stevens-Johnson syndrome （SJS） and toxic epidermal necrolysis （TEN） induced by tislelizumab， providing evidence for clinical medication safety. METHODS Case reports of tislelizumab-related SJS/TEN were retrieved from CNKI， VIP， Wanfang Data， PubMed， ScienceDirect， and Embase. Descriptive analysis was performed. RESULTS Seventeen cases from 17 publications were included （SJS 4 cases， TEN 13 cases）. Among them， there were 10 males and 7 females. Twelve patients were aged between 70 and 79 years. The predominant tumor type was lung cancer （10 cases）. Thirteen patients received combination therapy with chemotherapeutic drugs. The median onset time of SJS/ TEN was 26 （4， 104） days. Nine patients developed SJS/TEN after the first administration of the drug. Sixteen patients exhibited prodromal rash symptoms， primarily characterized by severe skin damage such as skin detachment， accompanied by mucosal injury. Sixteen patients improved after symptomatic treatment， while one patient died. CONCLUSIONS Tislelizumab-associated SJS/TEN risk is higher in elderly patients， males， those with lung cancer and those receiving combination chemotherapy. Mucosal lesions and atypical rashes may indicate the early onset of SJS/TEN. During clinical use， pharmaceutical care can be carried out through measures such as identifying high-risk populations， closely monitoring skin symptoms from the first administration to the fifth treatment cycle， and enhancing patient education. When relevant symptoms occur， the medication should be promptly discontinued and symptomatic treatment should be administered to ensure the patient’s medication safety. |
| 期刊： | 2025年第36卷第16期 |
| 作者： | 韩锐；沈明曦；杨华；冀召帅 |
| AUTHORS： | HAN Rui，SHEN Mingxi，YANG Hua，JI Zhaoshuai |
| 关键字： | 替雷利珠单抗；史-约综合征；中毒性表皮坏死松解症；不良反应；文献分析 |
| KEYWORDS： | tislelizumab； Stevens-Johnson syndrome； toxic epidermal necrolysis； adverse drug reactions； literature analysis |
| 阅读数： | 8 次 |
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