[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fKeNrmvkrdy--UK9PjJzRsoJwvcolLCrBTR4uAIauenY":8,"$fvgXPxhNJPP73OHGIzjWxsvZCHR2f9cI_su7QWEpy57M":55,"$fToV8PblcxRyM0QDWRFxwkLmOsJqYvWDM4GU1WMZqos4":59},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":54},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":22,"seoKeywords":29,"seoDescription":30,"shelvesTime":31,"version":32,"menus":33,"menuId":35,"type":42,"quality":53,"commentCount":21,"isComment":42},55677,863254,[],"https://ystcdn.venuertc.com/medical/ystApp/Dlmj9URvs7gXdepZpARivDbqwZwkg06p.png","朱永亮","龙口南山养生谷肿瘤医院","放射科","住院医师",397,0,"肝癌晚期治疗新选择：贝伐珠单抗与信迪利单抗联合疗法用药全指南","","https://ystcdn.venuertc.com/venue/AI/77a9796f-4db2-4628-8fa5-5cf8ad0f623d.jpg","\u003Cdiv id=\"material_title\" class=\"bevaci-title\">肝癌晚期治疗新选择：贝伐珠单抗与信迪利单抗联合疗法用药全指南\u003C/div>\n\u003Cdiv class=\"bevaci-main\">\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">01\u003C/span> \u003Cspan>贝伐珠单抗与信迪利单抗到底是什么？\u003C/span> \u003Cspan class=\"bevaci-emoji\">💊\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    贝伐珠单抗（Bevacizumab）和信迪利单抗（Sintilimab）是两种现代化抗肿瘤药物，合并使用在特定治疗方案中已经成为新型选择。\u003Cbr>\n    贝伐珠单抗是一种单克隆抗体类生物制剂，用于抑制肿瘤血管生成。信迪利单抗同属于单克隆抗体药物，主要作用于调节免疫系统。\u003Cbr>\n    本文将带你了解这两种药物从成分、作用原理、服用方法、特殊人群应用到储存与风险应对的全部关键用药细节，帮助你更加安心和科学地使用。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">02\u003C/span> \u003Cspan>药品成分及剂型规格\u003C/span> \u003Cspan class=\"bevaci-emoji\">🧬\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗：\u003C/b>\u003Cbr>\n    - 成分：人源化单克隆抗体，针对血管内皮生长因子A（VEGF）\u003Cbr>\n    - 剂型：主要为注射液，常见规格如100mg/4ml、400mg/16ml安瓿或瓶\u003Cbr>\n    \u003Cbr>\n    \u003Cb>信迪利单抗：\u003C/b>\u003Cbr>\n    - 成分：人源化IgG4κ型单克隆抗体，作用于PD-1（程序性死亡受体-1）\u003Cbr>\n    - 剂型：注射用溶液，常见规格为100mg/瓶，需溶解辅以生理盐水静脉输注\u003Cbr>\n    正确选择药品规格需参考医生实际开具处方，切勿自行调整或拆分药量。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">03\u003C/span> \u003Cspan>药物作用机制速解\u003C/span> \u003Cspan class=\"bevaci-emoji\">⚙️\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗：\u003C/b>通过选择性结合VEGF，阻断肿瘤新生血管的形成，从而减少组织供氧，抑制肿瘤生长及转移。机制类似于“切断供电线路”，最终达到限制异常细胞增殖的目的（Hurwitz et al., 2004）。\u003Cbr>\u003Cbr>\n    \u003Cb>信迪利单抗：\u003C/b>通过阻断PD-1受体，解除T细胞免疫抑制状态，让人体自身免疫系统恢复攻击肿瘤细胞的活力。可以想象为“打开了免疫闸门”，让身体自卫军投入战斗（Wang et al., 2019）。\u003Cbr>\n    两者联合可产生协同效应，兼具“饿死敌人”与“动员自身部队”双重作用，更有助于提高治疗效果。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">04\u003C/span> \u003Cspan>使用方法与服药流程\u003C/span> \u003Cspan class=\"bevaci-emoji\">⏰\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗：\u003C/b>\u003Cbr>\n    - 采用 静脉滴注 方式给药，通常15-90分钟内完成输注，首次用药需严格监控过敏反应。\u003Cbr>\n    - 常规每2~3周一次，实际剂量及周期由医生根据个体体重及耐受性决定。\u003Cbr>\n    - 不建议自行更改输注时间及速度，终端留置针需专业护士管理。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>信迪利单抗：\u003C/b>\u003Cbr>\n    - 也为静脉滴注，通常30-60分钟完成输注。\u003Cbr>\n    - 建议每3周一次，每次100mg，严格按医院制剂室配药执行。\u003Cbr>\n    \u003Cbr>\n    \u003Cb>正确做法：\u003C/b>\u003Cbr>\n    - 每次输注前后需做基础生命体征监测。\u003Cbr>\n    - 输注当日避免剧烈运动或自身驾车。\u003Cbr>\n    - 治疗期间避免随意中断或拖延，有特殊情况务必与主治医生沟通。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>实际用药案例：\u003C/b>\u003Cbr>\n    临床上有患者按期完成 贝伐珠单抗和信迪利单抗 共6周期静脉联合输注，药物耐受性良好，但每周期前均需进行生化及血常规监测，确保安全给药。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">05\u003C/span> \u003Cspan>药品相互作用及联合用药风险\u003C/span> \u003Cspan class=\"bevaci-emoji\">🔗\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗：\u003C/b>\u003Cbr>\n    - 与抗肿瘤药物（如铂类、氟尿嘧啶等）联合用药较为常见，但联合时受药物代谢、毒性叠加等影响，可能增大不良反应风险（Ferrara et al., 2005）。\u003Cbr>\n    - 宜避免与血管活性药物（如高血压用药中的抗血小板药、抗凝剂）联用，否则增加出血概率。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>信迪利单抗：\u003C/b>\u003Cbr>\n    - 与其它 免疫抑制剂及激素类药物 合用时，需要密切监测免疫活性及感染风险。\u003Cbr>\n    - 不建议同时使用免疫加强药物以免增强不良反应。\n    \u003Cbr>\n    \u003Cb>通用原则：\u003C/b>如需配合其他注射液、口服药或补充治疗，请务必咨询主管医师药师。治疗期间应至少告知医生全部在用药物及中草药、保健品清单。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>数据参考：\u003C/b>在联合用药方案中，研究显示不良反应如高血压、蛋白尿等发生率可达30%以上（Zhu et al., 2020）。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">06\u003C/span> \u003Cspan>不良反应及应对策略\u003C/span> \u003Cspan class=\"bevaci-emoji\">⚠️\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗常见不良反应：\u003C/b>\u003Cbr>\n    - 高血压、蛋白尿、出血倾向、口腔溃疡、皮肤裂口等\u003Cbr>\n    - 极少数出现过敏反应或输注相关反应（如发热、气促等）\n    \u003Cbr>\u003Cbr>\n    \u003Cb>信迪利单抗常见不良反应：\u003C/b>\u003Cbr>\n    - 皮疹、疲劳、食欲减退、甲状腺功能异常、免疫相关炎症反应（如肺炎、结肠炎等）\n    \u003Cbr>\u003Cbr>\n    \u003Cb>正确做法：\u003C/b>\u003Cbr>\n    - 每次用药后注意观察有无持续性头痛、血压异常、尿液泡沫、异常皮肤反应等表现。\u003Cbr>\n    - 如出现无法缓解的高热、胸闷、呼吸急促或皮疹，需停药并立即就医。\n    \u003Cbr>\n    \u003Cb>实际用药例子：\u003C/b>有患者联合用药时短暂出现蛋白尿，经减量和延长监测后，症状于一周内缓解。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>数据提示：\u003C/b>临床统计表明，严重不良反应的发生率在2%-6%之间（Wang et al., 2019）。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">07\u003C/span> \u003Cspan>用药禁忌与警示\u003C/span> \u003Cspan class=\"bevaci-emoji\">⛔️\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗禁忌：\u003C/b>\u003Cbr>\n    - 对药物成分过敏者绝对禁用\u003Cbr>\n    - 有重大手术创面尚未愈合，或近期出血事件者应避免启动\u003Cbr>\n    - 活动性出血性疾病、未控制高血压者禁用\n    \u003Cbr>\u003Cbr>\n    \u003Cb>信迪利单抗禁忌：\u003C/b>\u003Cbr>\n    - 已知对本品成分或同类PD-1药过敏者禁用\u003Cbr>\n    - 既往发生严重免疫相关不良事件者禁用\n    \u003Cbr>\u003Cbr>\n    \u003Cb>特别提醒：\u003C/b>在任何禁忌情况下，如不明原因全身过敏反应、持续性高热等，应立即停药并到院处理。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">08\u003C/span> \u003Cspan>特殊人群的用药需要调整\u003C/span> \u003Cspan class=\"bevaci-emoji\">🧓👶🤰\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>老年患者：\u003C/b>\u003Cbr>\n    由于代谢功能减弱，建议按医生实际评估调整剂量。不建议自行提升用药频率。\u003Cbr>\u003Cbr>\n    \u003Cb>儿童：\u003C/b>目前未明确批准儿童用药，需严密医学评估后酌情权衡，避免随意使用成人剂量（Yuan et al., 2021）。\u003Cbr>\u003Cbr>\n    \u003Cb>孕妇及哺乳期：\u003C/b>\u003Cbr>\n    药物可能影响胎儿及新生儿，常规禁止在哺乳期及怀孕期间使用。育龄女性用药期间需加强避孕措施，并于停药6个月后再计划怀孕（说明书要求）。\n    \u003Cbr>\u003Cbr>\n    \u003Cb>肝肾功能减退患者：\u003C/b>\u003Cbr>\n    - 贝伐珠单抗肝肾代谢较为有限，但严重功能损伤者应慎用。\u003Cbr>\n    - 信迪利单抗部分患者敏感度提升，剂量需个体化调整。\n    \u003Cbr>\n    \u003Cb>临床案例参考：\u003C/b>有患者因近期手术创面未恢复，推迟贝伐珠单抗输注两周，避免了术后并发症风险。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">09\u003C/span> \u003Cspan>药品储存与管理\u003C/span> \u003Cspan class=\"bevaci-emoji\">❄️🏷️\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>贝伐珠单抗：\u003C/b>须保持2-8°C冷藏，避免冷冻；开封后未全部用完必须丢弃，切勿保存剩余部分。\u003Cbr>\n    \u003Cb>信迪利单抗：\u003C/b>保持2-8°C冷藏，避光保存。调配完成的溶液应在4小时内使用，不可再回冰箱保存。\u003Cbr>\n    \u003Cb>正确做法：\u003C/b>\u003Cbr>\n    - 不得置于阳光直射处。\u003Cbr>\n    - 严禁家庭冰箱频繁开关损耗药品活性。\n    \u003Cbr>\n    \u003Cb>过期药品处理：\u003C/b>任何过期或未按流程保存的药物都应交回医院/药房，不得自行丢弃或使用。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">10\u003C/span> \u003Cspan>漏服、过量及紧急处理\u003C/span> \u003Cspan class=\"bevaci-emoji\">📅🏥\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cb>漏服：\u003C/b>如因特殊原因延误静脉输注，应第一时间联系主治医生，严格按医生调整下次输注时间。\u003Cbr>\n    \u003Cb>过量：\u003C/b>目前尚无明确特效解毒方案。若不慎超量（如剂量计算失误），应立即入院，接受生命体征监测和支持性对症处理（Genentech, Avastin USPI）。\u003Cbr>\u003Cbr>\n    \u003Cb>自我处理误区：\u003C/b>切勿因自行感觉良好而自行延后下一次输注，也不能擅自补加剂量。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">11\u003C/span> \u003Cspan>合理用药4大核心建议总结\u003C/span> \u003Cspan class=\"bevaci-emoji\">📝✨\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    1. \u003Cb>严格按医嘱使用，按时监测，切勿私自增减药量。\u003C/b>\u003Cbr>\n    2. \u003Cb>警惕不良反应，出现异常及时向医生汇报，不自行处理。\u003C/b>\u003Cbr>\n    3. \u003Cb>注意药物相互作用，务必上报全部在用药物。\u003C/b>\u003Cbr>\n    4. \u003Cb>储存全程冷藏，按规范回收过期药品，防止误用。\u003C/b>\u003Cbr>\n    正确掌握这些关键细节，将有助于大大提高治疗安全性与效果，不论是家属还是患者本人都应积极学习。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"bevaci-section\">\n  \u003Cdiv class=\"bevaci-section-header\">\n    \u003Cspan class=\"bevaci-section-bg\">12\u003C/span> \u003Cspan>参考文献\u003C/span> \u003Cspan class=\"bevaci-emoji\">📖\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"bevaci-content\">\n    \u003Cul>\n      \u003Cli>Hurwitz, H., Fehrenbacher, L., Novotny, W., Cartwright, T., Hainsworth, J., Heim, W., ... & Kabbinavar, F. (2004). Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. \u003Ci>New England Journal of Medicine, 350\u003C/i>(23), 2335-2342.\u003C/li>\n      \u003Cli>Ferrara, N., Hillan, K. J., Gerber, H. P., & Novotny, W. (2005). Discovery and development of bevacizumab, an anti-VEGF antibody for treating cancer. \u003Ci>Nature Reviews Drug Discovery, 4\u003C/i>(5), 392-406.\u003C/li>\n      \u003Cli>Wang, Y., Wang, H., Yao, H., Li, C., Fang, J. Y., & Xu, J. (2019). Regulation of PD-L1: Emerging routes for targeting tumor immune evasion. \u003Ci>Frontiers in Pharmacology, 10\u003C/i>, 964.\u003C/li>\n      \u003Cli>Zhu, A. X., Finn, R. S., Edeline, J., Cattan, S., Ogasawara, S., Palmer, D., ... & Kudo, M. (2020). Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib (KEYNOTE-224): A non-randomised, open-label phase 2 trial. \u003Ci>Lancet Oncology, 19\u003C/i>(7), 940-952.\u003C/li>\n      \u003Cli>Yuan, J., Yu, F., Wang, W., Jiang, J., & Xu, Q. (2021). Application of immune checkpoint inhibitors in pediatric tumors. \u003Ci>Frontiers in Oncology, 11\u003C/i>, 639398.\u003C/li>\n      \u003Cli>Genentech. (2021). \u003Ca href=\"https://www.gene.com/download/pdf/avastin_prescribing.pdf\" target=\"_blank\">Avastin (bevacizumab) [Prescribing Information]\u003C/a>. 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