目的 研究纳武利尤单抗相关胰腺炎的临床特征，为更好地识别纳武利尤单抗相关胰腺炎提供依据。方法 检索PubMed、Embase、Web of Science、中国知网、万方数据知识服务平台、维普资讯、中国生物医学文献服务系统的纳武利尤单抗相关胰腺炎的病例报道，提取患者的性别、年龄、用药情况、发生时间、临床表现、不良反应处理及转归等信息。结果 共纳入20例患者，男性12例，60岁及以上13例，免疫相关性胰腺炎发生在首次用药后第1～730天，中位数为第129天。临床症状主要为腹痛，实验室检查主要为脂肪酶、血淀粉酶升高，影像学检查主要表现为胰腺肿大，渗出。大部分经停药及给予糖皮质激素治疗后好转或痊愈。结论 在使用纳武利尤单抗期间应密切关注腹痛等临床症状，警惕免疫相关性胰腺炎的发生。临床症状及实验室检查与普通胰腺炎相比缺乏特异性，治疗方案与普通胰腺炎差别较大，应尽早鉴别免疫相关性胰腺炎，及时处理。
Literature analysis on immune-related pancreatitis secondary to nivolumab
Objective To investigate the clinical characteristics of immune-related pancreatitis secondary to nivolumab and provide a basis for better identification of this condition.Methods Case reports of immune-related pancreatitis secondary to nivolumab were retrieved from PubMed,Embase,Web of Science,CNKI,Wanfang Data,VIP,and SinoMed.Data extract-ed included patient gender,age,medication history,onset time,clinical manifestations,management of adverse reactions,and outcomes.Results A total of 20 patients were included,with 12 being male and 13 aged 60 years or older.Immune-re-lated pancreatitis occurred between 1 to 730 days after the first dose of nivolumab,with a median of 129 days.Clinical symp-toms mainly included abdominal pain,while laboratory findings showed elevated lipase and amylase levels.Imaging examina-tions revealed pancreatic enlargement and effusion.Most patients showed improvement or recovery after drug cessation and treatment with corticosteroids.Conclusion Vigilance for clinical symptoms such as abdominal pain should be maintained dur-ing nivolumab treatment to promptly identify immune-related pancreatitis.Clinical symptoms and laboratory findings lack specificity compared to typical pancreatitis,and treatment strategies differ significantly.Early identification and timely manage-ment of immune-related pancreatitis are crucial.
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