免疫检查点抑制剂应用于肝细胞癌造成肝脏不良事件的分析
Analysis of Liver Adverse Events Caused by the Application of Immune Checkpoint Inhibitors in Hepatocellular Carcinoma
摘要: 目的：分析肝细胞癌(HCC)患者接受程序性细胞死亡蛋白-1 (PD-1)抑制剂治疗的临床特点及肝毒性的影响因素，为HCC患者免疫相关肝毒性的治疗提供理论依据。方法：回顾性分析安医大二附院2019年9月至2024年8月HCC患者的临床资料，以总结和统计分析免疫相关肝脏不良反应的影响因素。结果：共有156例HCC患者纳入研究，其中38例出现免疫治疗相关的肝毒性，发生率为24%。影响因素和肝脏不良反应的统计分析显示，年龄、总胆红素水平和Child-Pugh分型是影响接受免疫检查点抑制剂治疗的HCC患者肝脏不良反应发生的主要因素(P < 0.05)。结论：对于60岁以上、胆红素水平 ≥ 50 μmol/L且肝功能分级高于A级的HCC患者，建议密切观察免疫治疗期间免疫相关不良反应的发生。
Abstract: Objective: To analyze the clinical characteristics of patients with hepatocellular carcinoma (HCC) treated with programmed cell death protein-1 (PD-1) inhibitors and the influencing factors of hepatotoxicity, and to provide a theoretical basis for the treatment of immune-related hepatotoxicity in HCC patients. Methods: The clinical data of HCC patients in the Second Affiliated Hospital of Anhui Medical University from September 2019 to August 2024 were retrospectively analyzed to summarize and statistically analyze the influencing factors of immune-related adverse liver reactions. Results: A total of 156 HCC patients were included in the study, among which 38 cases developed immune therapy-related hepatotoxicity, with an incidence rate of 24%. The statistical analysis of the influencing factors and adverse liver reactions showed that age, total bilirubin level, and Child-Pugh classification were the main factors affecting the occurrence of adverse liver reactions in HCC patients treated with immune checkpoint inhibitors (P < 0.05). Conclusion: For HCC patients aged over 60 years old, with a bilirubin level ≥ 50 μmol/L, and a liver function grade higher than grade A, it is recommended to closely observe the occurrence of immune-related adverse reactions during immunotherapy.
文章引用：汪晚晴, 章礼久. 免疫检查点抑制剂应用于肝细胞癌造成肝脏不良事件的分析[J]. 临床医学进展, 2025, 15(5): 1307-1315. https://doi.org/10.12677/acm.2025.1551495

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