仑伐替尼致冠状动脉重度狭窄1例并文献复习

Severe Coronary Artery Stenosis Induced by Lenatinib: A Case Report with Literature Review

关键词:  仑伐替尼  冠状动脉狭窄  不良反应  文献复习

Key words:  Lenvatinib  coronary artery stenosis  adverse drug reaction  literature review

摘要:

目的 探讨肝癌患者应用仑伐替尼后发生冠状动脉重度狭窄的潜在关联性及可能机制，为临床合理用药提供参考。方法 回顾性分析1例肝癌患者使用仑伐替尼治疗后出现冠状动脉重度狭窄的临床诊疗过程，结合相关文献，评估用药与不良反应的因果关系，并探讨其可能的致病机制。结果 通过诺氏（Naranjo’s）评估量表量化评分，总分为8分（提示因果关系为“很可能”）。结论 仑伐替尼所致冠状动脉重度狭窄可能与内皮修复功能抑制、血管内皮功能障碍及慢性炎症反应激活、斑块形态特征改变、血流动力学异常及侧支循环代偿受损等因素相关，临床医生在启动仑伐替尼治疗前，应常规对患者进行详细的心血管风险评估，优化血压、血糖和血脂管理，做到早发现、早干预。

Abstract:

OBJECTIVE To investigate the Link and Potential Mechanisms of Lenatinib-Induced Severe Coronary Artery Stenosis in Hepatocellular Carcinoma Patients，and provide a reference for clinical rational drug use.METHODS A Retrospective Analysis of Clinical Management, Causality Assessment, and Potential Mechanisms in a Case of Lenvatinib-Induced Severe Coronary Artery Stenosis in a Patient with Hepatocellular Carcinoma.RESULTS The Naranjo’s adverse drug reaction probability scale yielded a score of 8, indicating a 'probable' causal relationship. CONCLUSION The pathogenesis of lenvatinib-induced severe coronary artery stenosis may be associated with multiple factors, including inhibited endothelial repair function, vascular endothelial dysfunction, activation of chronic inflammatory responses, alterations in plaque morphological characteristics, hemodynamic abnormalities, and compromised compensation from collateral circulation.Before initiating lenvatinib therapy, clinicians should routinely conduct a detailed cardiovascular risk assessment for patients, optimize management of blood pressure, blood glucose, and blood lipids, and ensure early detection and intervention.