免疫检查点抑制剂相关心肌炎监测与管理中国专家共识(2020版).pdf

中国肿瘤临床2020年第47卷第20期 ChinJClinOncol2020.Vol.47.No.20 1027 专家共识 · · 免疫检查点抑制剂相关心肌炎监测与管理中国专家共识（2020版）* 中国抗癌协会整合肿瘤心脏病学分会 中华医学会心血管病学分会肿瘤心脏病学学组 中国医师协会心血管内科医师分会肿瘤心脏病学专业委员会 中国临床肿瘤学会肿瘤心脏病学专家委员会 摘要 免疫检查点抑制剂（immunecheckpointinhibitors，ICIs）为肿瘤患者带来显著生存获益的同时，其致命性的药物相关心肌炎 并发症成为临床中的新挑战。本共识总结ICIs相关心肌炎的流行病学、病理特点、临床特点、诊断与鉴别诊断、临床分型和对应 管理方案，提出主动监测策略（proactivemonitoringstrategy，PMS）以发现早期心肌损伤，为ICIs相关心肌炎的监测和管理提供指导 意见和建议。 关键词 肿瘤心脏病学 免疫治疗 免疫检查点抑制剂 心血管疾病 心肌炎 doi:10.3969/j.issn.1000-8179.2020.20.148 Chinese expert consensus on the surveillance and management of immune checkpoint inhibitor-related myocarditis (2020 version) Society of Integrative Cardio-Oncology China Anti-Cancer Association, The Cardio-Oncology Group of the Chinese Society of Cardiovas- cular Diseases of Chinese Medical Association, Chinese College of Cardiovascular Physicians Specialized Committee on Cardio-Oncolo- gy Chinese Medical Docotor Association, The Chinese Society of Clinical Oncology Expert Committee on Cardio-Oncology Correspondence to: Zhiren Zhang; E-mail: zhirenz@163.com This work was supported by the National Natural Science Foundation of China (No., and Nn10 Program of Harbin Medical University Cancer Hospital (No.Nn10 2017-04) Abstract While immune checkpoint inhibitors (ICIs) confer significant survival benefits in patients with cancer, drug-related myocardi- tis, a fatal complication, has become a new clinical challenge. This consensus statement summarizes the data on the epidemiology, pathological characteristics, clinical features, diagnosis and differential diagnosis, clinical classification, and treatment of ICI- related myocarditis, with a special focus on proactive monitoring strategies for detecting early myocardial