【摘要】 1例76岁男性小细胞肺癌患者，在使用度伐利尤单抗治疗5个周期后，出现乏力、胸闷不适，实验室检查：血糖31.69 mmol/L,钾6.28 mmol/L,钠126 mmol/L,氯93 mmol/L,HCO^-₃ 5.9 mmol/L,酮体阳性，pH值为7.087。考虑为糖尿病酮症酸中毒，经过胰岛素降糖，补液、补钠、补碱等对症治疗，后患者症状逐渐好转。通过对度伐利尤单抗不良反应相关文献进行复习，进一步分析度伐利尤单抗导致糖尿病酮症酸中毒的发生机制、临床表现、危险因素及治疗预后，以期为临床合理用药提供参考。更多还原

【Abstract】 A 76-year-old man with small cell lung cancer had fatigue and chest discomfort after 5 cycles of durvalumab treatment.Laboratory tests showed blood glucose 31.69 mmol/L,potassium 6.28 mmol/L,sodium 126 mmol/L,chlorine 93 mmol/L,HCO₃^- 5.9 mmol/L,ketone positive, pH 7.087.The patient was considered to be with diabetic ketoacidosis.After reducing blood glucose by insulin, fluid supplementation, sodium supplementation, alkali supplementation and other symptomatic treatment, the patient′s symptoms were gradually improved.By reviewing literatures related to the adverse reactions of durvalumab, the pathogenesis, clinical manifestations, risk factors and treatment prognosis of diabetic ketoacidosis caused by durvalumab were further analyzed, with an aim to provide references for clinical rational drug use.更多还原