1例73岁女性左肺中央型鳞状上皮癌患者接受纳武利尤单抗注射液200 mg静脉滴注1次。治疗后第16天，患者出现左侧眼睑下垂、呼吸急促，肌酸激酶（CK）21 378 U/L、CK-MB 529 U/L、N端脑钠肽前体（NT-BNP）8 783 ng/L、丙氨酸转氨酶（ALT）350 U/L。治疗后第25天，心电监护示频发室上性和室性心动过速；胸部X线检查示两肺纹理增多；高敏人肌钙蛋白T（hs-cTnT）1 722 ng/L，NT-BNP 2 385 ng/L，白细胞计数（WBC）18.5×10n 9/L，中性粒细胞计数17.9×10n 9/L，血清游离三碘甲状腺原氨酸（FTn 3）2.66 pmol/L，促甲状腺激素（TSH）0.16 mU/L，甲状腺过氧化物酶抗体（TPO-Ab）61 kU/L，甲状腺球蛋白抗体（TG-Ab）62 kU/L。考虑为纳武利尤单抗相关免疫性肌炎、心肌炎、肺炎、甲状腺功能异常和肝功能异常，给予糖皮质激素、抗感染和抗心律失常等治疗。7 d后患者恢复窦性心律，hs-cTnT降至847 ng/L，ALT和天冬氨酸转氨酶分别为51 U/L和31 U/L；34 d后WBC 6.8×10n 9/L，中性粒细胞0.70；37 d后患者恢复自主呼吸；49 d后患者肌力明显恢复，NT-BNP 185 ng/L、hs-cTnT 687 ng/L；除TSH 16.03 mU/L外，其他甲状腺相关检测指标均恢复至参考值范围。n “,”A 73-year-old female patient with central squamous cell carcinoma of left lung received one dose treatment of IV infusion of nivolumab 200 mg. On the 16th day after nivolumab treatment, the patient developed left eyelid ptosis and shortness of breath. Laboratory tests showed creatine kinase (CK) 21 378 U/L, CK-MB 529 U/L, N-terminal pro-B-type natriuretic peptide (NT-BNP) 8 783 ng/L, alanine aminotransferase (ALT) 350 U/L. On the 25th day after nivolumab treatment, laboratory tests showed high-sensitivity human troponin T (hs-cTnT) 1 722 ng/L, NT-BNP 2 385 ng/L, white blood cell count (WBC) was 18.5×10n 9/L, neutrophil count was 17.9×10n 9/L, serum free triiodothyronine (FTn 3) 2.66 pmol/L, thyroid stimulating hormone (TSH) 0.16 mU/L, thyroid peroxidase antibody (TPO-Ab) 61 U/ml, and thyroglobulin antibody (TG-Ab) 62 U/ml. Nivolumab-related immune myositis, myocarditis, pneumonia, and abnormal thyroid function and liver function were considered. Glucocorticoid, anti-infection, and anti-arrhythmia treatments, etc. were given. Seven days later, sinus rhythm in the patient was recovered, hs-cTnT decreased to 847 ng/L, ALT and aspartate aminotransferase were 51 U/L and 31 U/L, respectively; 34 days later, WBC was 6.8×10n 9/L and neutrophils percentage was 0.70; 37 days later, the patient returned to spontaneous breathing; 49 days later, the patient′s muscle strength recovered significantly, NT-BNP was 185 ng/L, and hs-cTnT was 687 ng/L. Except that TSH was 16.03 mU/L, other indexes related to thyroid returned to the reference value range.n