中国药物警戒 ›› 2025, Vol. 22 ›› Issue (4): 463-465.
DOI: 10.19803/j.1672-8629.20240503

• 安全与合理用药 • 上一篇    下一篇

甲磺酸伊马替尼片致胃间质瘤患者间质性肺炎1例分析

谌琦1, 张明强2, 郭军1,2,*   

  1. 1清华大学北京清华长庚医院老年医学科,北京 102218;
    2清华大学北京清华长庚医院呼吸与危重症医学科,北京 102218
  • 收稿日期:2024-07-26 发布日期:2025-04-17
  • 通讯作者: *郭军,男,主任医师,呼吸与危重症医学。E-mail: junguo_med@tsinghua.edu.cn
  • 作者简介:谌琦,女,硕士,住院医师,呼吸与危重症医学。
  • 基金资助:
    北京市卫生健康委员会高层次公共卫生技术人才建设项目培养计划（12022B4004）

One Case of Interstitial Pneumonia Caused by Imatinib Mesylate Tablets during the Treatment of Gastric Stromal Tumor

CHEN Qi1, ZHANG Mingqiang2, GUO Jun1,2,*   

  1. 1Department of Geriatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine Tsinghua University, Beijing 102218, China;
    2Department of Respiratory and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine Tsinghua University, Beijing 102218, China
  • Received:2024-07-26 Published:2025-04-17

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摘要： 目的 分析甲磺酸伊马替尼片治疗胃间质瘤过程中引起间质性肺炎的临床表现、严重程度分级、处理措施及预后,为临床用药提供参考。方法 对1例口服甲磺酸伊马替尼片治疗胃间质瘤过程中出现间质性肺炎患者的临床资料进行分析,并对国内外文献进行回顾总结。结果 本例患者使用甲磺酸伊马替尼片治疗时出现咳嗽、咳痰,经关联性分析及多学科会诊讨论后判断为甲磺酸伊马替尼片所致间质性肺炎,停药并予糖皮质激素治疗后,患者临床症状及影像学表现逐渐好转。文献分析显示甲磺酸伊马替尼片可引起间质性肺炎,临床常见症状为呼吸困难、咳嗽、咳痰、气短。胸部CT多表现为磨玻璃影及网格状纤维化改变,临床严重程度可分为4级,及时治疗预后良好。结论 临床使用甲磺酸伊马替尼片治疗胃间质瘤前应注意药品不良反应,做好用药评估。用药过程中若患者出现呼吸系统症状,应及时完善相关检查,疑诊甲磺酸伊马替尼片诱导的间质性肺炎时应由多学科团队进行全面评估,根据严重程度分级采取相应治疗措施,改善患者预后。

关键词: 甲磺酸伊马替尼, 胃间质瘤, 药物性肺损伤, 间质性肺炎, 药品不良反应

Abstract: Objective To analyze the clinical manifestations, severity grading, management, and prognosis of interstitial pneumonitis that occurred during the treatment of gastric stromal tumors with imatinib mesylate tablets so as to provide guidance for clinicians. Methods The clinical data of a patient who developed interstitial pneumonitis during the treatment of her gastric stromal tumor with oral imatinib mesylate was analyzed. Additionally, the related literature was reviewed and summarized. Results The patient developed cough and sputum while she was treated with imatinib mesylate. After correlation analysis and multidisciplinary consultation, the patient was diagnosed with imatinib-induced interstitial pneumonia. Imatinib mesylate was discontinued, and glucocorticoid therapy was initiated. The patient’s clinical symptoms and imaging findings gradually improved. Literature review showed that imatinib mesylate could cause interstitial pneumonia, with such common clinical symptoms as dyspnea, cough, sputum production and shortness of breath. Chest CT often showed ground-glass opacities and reticular fibers. The clinical severity of the condition could be classified into four grades, and immediate treatment led to a good prognosis. Conclusion Clinicians should be alert to the risk of adverse drug reactions and conduct a safety assessment before using imatinib mesylate. In case of respiratory symptoms during treatment, a range of examinations is recommended. If imatinib-induced interstitial pneumonitis is considered likely, the multidisciplinary team should carry out an all-round assessment and adopt the right treatment regimen according to the severity grade to improve the patient’s prognosis.

Key words: Imatinib Mesylate, Gastric Stromal Tumor, Drug-Related Lung Injury, Interstitial Pneumonia, Adverse Drug Reaction

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