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生物标志物对免疫检查点抑制剂相关心肌炎患者激素抵抗及预后的预测价值

王尹曼蔡青青王妍刘媛吕迁洲程蕾蕾

中国临床医学2026，Vol.33Issue(4)：607-614,8.

中国临床医学2026，Vol.33Issue(4)：607-614,8.DOI:10.12025/j.issn.1008-6358.2026.20260423

生物标志物对免疫检查点抑制剂相关心肌炎患者激素抵抗及预后的预测价值

Predictive value of biomarkers for steroid resistance and prognosis in patients with immune checkpoint inhibitor-associated myocarditis

王尹曼 ¹蔡青青 ²王妍 ³刘媛 ¹吕迁洲 ⁴程蕾蕾⁵

作者信息

1. 复旦大学附属中山医院心内科,上海 200032||上海市心血管病研究所,上海 200032||心脏病全国重点实验室,上海 200032||国家放射与治疗临床医学研究中心,上海 200032||复旦大学肿瘤心脏病研究所(筹),上海 200032
2. 复旦大学肿瘤心脏病研究所(筹),上海 200032||复旦大学附属中山医院药剂科,上海 200032
3. 复旦大学肿瘤心脏病研究所(筹),上海 200032||复旦大学附属中山医院肿瘤内科,上海 200032
4. 复旦大学附属中山医院药剂科,上海 200032
5. 上海市心血管病研究所,上海 200032||心脏病全国重点实验室,上海 200032||复旦大学肿瘤心脏病研究所(筹),上海 200032||复旦大学附属中山医院心脏超声诊断科,上海 200032||上海市影像医学研究所,上海 200032
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摘要

Abstract

Objective To investigate predictive value of soluble growth stimulation-expressed gene 2 protein(sST2),cardiac troponin T(cTnT),and creatine kinase-myocardial band(CK-MB)for steroid resistance and prognosis in patients with immune checkpoint inhibitor-associated myocarditis(ICIAM).Methods A total of 28 patients with ICIAM were prospectively enrolled from March 2023 to February 2024 at Zhongshan Hospital,Fudan University.All participants were divided into the steroid-resistant ICIAM(srICIAM)group and the non-srICIAM group.Baseline serum levels of sST2,cTnT and CK-MB were detected prior to treatment initiation.ROC curve analysis was applied to evaluate the predictive value of these biomarkers,and Kaplan-Meier survival analysis was performed to explore the relationship between sST2 and all-cause mortality.Results Baseline sST2,cTnT,and CK-MB levels were significantly higher in the srICIAM group(n=15)than in the non-srICIAM group(n=13,P＜0.05).Combination of cTnT and sST2 improved predictive performance for srICIAM(AUC=0.857,sensitivity 0.714,specificity 1.000).After 6 months of follow-up,the high sST2 group had a significantly higher all-cause mortality than the low sST2 group(P=0.016).Conclusions The combination of sST2 and cTnT could effectively predict srICIAM,and elevated sST2 is associated with increased higher all-cause mortality in ICIAM patients,providing a basis for early risk stratification and treatment optimization.

关键词

免疫检查点抑制剂相关心肌炎/生长刺激表达基因2蛋白/心肌肌钙蛋白T/激素抵抗/预后

Key words

immune checkpoint inhibitor-associated myocarditis/growth stimulation expressed gene 2 protein/cardiac troponin T/steroid resistance/prognosis

分类

医药卫生

引用本文复制引用

王尹曼,蔡青青,王妍,刘媛,吕迁洲,程蕾蕾..生物标志物对免疫检查点抑制剂相关心肌炎患者激素抵抗及预后的预测价值[J].中国临床医学,2026,33(4):607-614,8.

基金项目

四大慢病重大专项(2023ZD0502800),国家自然科学基金(82170359、82470354).Supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project(2023ZD0502800)and National Natural Science Foundation of China(82170359,82470354). （2023ZD0502800）

中国临床医学

ISSN：1008-6358

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