目的 探索帕博利珠单抗致甲状腺功能障碍发生的规律和临床特点，为临床安全用药提供参考。方法 检索知网、维普、万方、PubMed、Web of Science数据库，收集关于帕博利珠单抗致免疫性皮肤病的文献数据并进行统计分析。结果 纳入16篇文献，共16例甲状腺功能障碍病例，年龄为30～77岁；甲状腺功能障碍发生时间最早为给药后14 d，最晚为给药后240 d；常规给予左甲状腺素治疗甲状腺功能减退及给予甲硫咪唑治疗甲状腺功能亢进，经过治疗后多数患者甲状腺功能障碍好转。结论 在使用帕博利珠单抗时要注意监测甲状腺功能障碍不良反应，一旦发生应及时进行相应治疗。

Objective To explore the regularity and clinical characteristics of thyroid dysfunction caused by pembrolizumab, so as to provide reference for clinical application. Methods Literatures of thyroid dysfunction induced by pembrolizumab were collected and statistically analyzed by searching CNKI, VIP database, Wanfang database, PubMed, and Web of Science. Results Totally, 16 patients with thyroid dysfunction caused by pembrolizumab were included, the range of age was 30 — 77 years. The earliest time of occurrence of thyroid dysfunction was 14 d after administration, and the lastest was 240 d after administration. Levothyroxine was routinely given to treat hypothyroidism and methiimidazole was given to treat hyperthyroidism. After treatment, the patients with thyroid dysfunction caused by pembrolizumab were improved. Conclusion When using pembrolizumab, we should pay attention to the monitoring of thyroid dysfunction adverse reactions, and take timely treatment once the adverse reactions occur.

R979.1

吴阶平医学基金会临床科研专项资助基金项目（320.6750.2020-11-26）