嵌合抗原受体T细胞治疗系统性硬化症并发细胞因子释放综合征患者的护理

doi:10.3761/j.issn.2096-7446.2026.10.013

Abstract

Abstract:

This report summarized the nursing management of cytokine release syndrome （CRS） in a patient with systemic sclerosis following chimeric antigen receptor T-cell （CAR-T） therapy. Given the patient’s severe baseline condition，rapid CRS progression，and complications including mucocutaneous injury and immunosuppression，a nursing-led CRS early-warning system was established. Refined infection prevention and control，and coordinated mucocutaneous repair strategy were implemented. The patient successfully navigated the acute phase post-CAR-T infusion，with progressive normalization of laboratory parameters，significant healing of oral ulcers，and improvement in skin induration. The patient was discharged on day 20 after infusion.

Key words: Systemic Sclerosis, Chimeric Antigen Receptor T-cell Therapy, Cytokine Release Syndrome, Critical Care Nursing

LU Chunning, REN Huanhuan, GAO Chao, XU Liling. Nursing care for one case of systemic sclerosis treated with chimeric antigen receptor T-cell complicated with cytokine release syndrome[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(10): 1226-1228.

References 11

[1]	Volkmann ER, Andréasson K, Smith V. Systemic sclerosis[J]. Lan-cet, 2023, 401(10373):304-318.
[2]	Rangel-Peláez C, Martínez-Gutiérrez L, Tristán-Manzano M, et al. CD19 CAR-T cell therapy:a new dawn for autoimmune rheu-matic diseases?[J]. Front Immunol, 2024, 15:1502712. doi: 10.3389/fimmu.2024.1502712
[3]	Li YP, Ming Y, Fu RQ, et al. The pathogenesis,diagnosis,pre-vention,and treatment of CAR-T cell therapy-related adverse reactions[J]. Front Pharmacol, 2022, 13:950923. doi: 10.3389/fphar.2022.950923
[4]	Liu YY, Fang YL, Chen XF, et al. Gasdermin E-mediated target cell pyroptosis by CAR T cells triggers cytokine release syn-drome[J]. Sci Immunol, 2020, 5(43):eaax7969. doi: 10.1126/sciimmunol.aax7969
[5]	Lee DW, Santomasso BD, Locke FL, et al. ASTCT consensus gra-ding for cytokine release syndrome and neurologic toxicity associated with immune effector cells[J]. Biol Blood Marrow Transplant, 2019, 25(4):625-638. doi: 10.1016/j.bbmt.2018.12.758
[6]	Khanna D, Furst DE, Clements PJ, et al. Standardization of the modified Rodnan skin score for use in clinical trials of sys-temic sclerosis[J]. J Scleroderma Relat Disord, 2017, 2(1):11-18. doi: 10.5301/jsrd.5000231
[7]	王璋琰, 洪煌明, 林桐榆. 淋巴瘤患者CAR-T治疗后毒副反应的管理与桥接治疗的研究进展[J]. 中国肿瘤, 2025, 34(9):734-741.
	Wang ZY, Hong HM, Lin TY. Research progress on the mana-gement of toxic and side effects and bridging therapy in patients with lymphoma after CAR-T treatment[J]. China Can-cer, 2025, 34(9):734-741.
[8]	林燕, 俞超, 王奉涛, 等. 2例异基因造血干细胞移植术后移植物抗宿主病患者行肺移植术的护理[J]. 中华护理杂志, 2022, 57(4):481-486. doi: 10.3761/j.issn.0254-1769.2022.04.015
	Lin Y, Yu C, Wang FT, et al. Nursing care for 2 patients with graft-versus-host disease after allogeneic hematopoietic stem cell transplantation who underwent lung transplantation[J]. Chin J Nurs, 2022, 57(4):481-486.
[9]	Beldner S, Rabinovich RV, Polatsch DB. Scleroderma of the hand:evaluation and treatment[J]. J Am Acad Orthop Surg, 2020, 28(16):e686-e695. doi: 10.5435/JAAOS-D-19-00547
[10]	罗彦, 张月英. 急性髓系白血病病人化疗后口腔黏膜炎的护理干预[J]. 护理研究, 2020, 34(1):150-154.
	Luo Y, Zhang YY. Nursing interventions for oral mucositis in patients with acute myeloid leukemia after chemotherapy[J]. Chin Nurs Res, 2020, 34(1):150-154.
[11]	罗霞. 优质护理在改善头颈部肿瘤放疗患者口腔黏膜炎中的效果分析[J]. 中华肿瘤防治杂志, 2018, 25(S1):196-197.
	Luo X. Analysis of the effect of high-quality nursing on improving oral mucositis in patients with head and neck cancer undergoing radiotherapy[J]. Chin J Cancer Prev Treat, 2018, 25(S1):196-197.

[1]	ZHONG Chenchen, ZHANG Liping, WEN Jiaqi, YE Yan, LIU Yu. A qualitative study on the symptom experience and multi-dimensional coping strategies of adult patients with myocarditis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(9): 1096-1100.
[2]	DING Yang, ZHUANG Yiyu, HUANG Ruiying, YE Shan. Nursing care of a patient with medullary infarction complicated by Mallory-Weiss tear following vertebral artery stenting [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(9): 1112-1114.
[3]	XU Zhe, YU Chao, WU Xiaoli. Nursing cooperation in PICC catheterization for patients with bilateral internal jugular vein thrombosis using magnetic navigation combined with intracardiac electrocardiogram technology [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(9): 1150-1152.
[4]	XU Zhe, XU Hongxia, FENG Feng, XIE Rui, WANG Feixia. Nursing experience of PICC catheterization in the right upper limb of a patient with isolated persistent left superior vena cava [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(8): 976-978.
[5]	MA Yanxin, WANG Guoying, HU Yuding, LIU Huiling. Pulmonary rehabilitation nursing for a patient with myofibrillar myopathy caused by a BAG3 gene mutation who had difficulty weaning from mechanical ventilation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(8): 982-985.
[6]	GUO Miao, YANG Yanjun, QIAO Li, YANG Tingting, ZHANG Ping. Study on the impact of humanistic care nursing based on the peak-end rule on satisfaction of ICU patients and their families [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 773-779.
[7]	YANG Li, XU Xiaobin, WANG Huafen. Application progress of functional near-infrared spectroscopy in critical care nursing [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 836-840.
[8]	ZHANG Yixiang, LÜ Wei, HE Cuili, LIU Liping, NONG Kang, XIE Fangna. Rapid identification and nursing for 109 patients with botulinum toxin type A injection-induced poisoning [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 846-848.
[9]	LIU Xiaoting, WANG Ping, XU Yihong, FAN Tingting, FU Zhenzhen, XIONG Zihan, HE Beilei, CHEN Xiaohui, ZHANG Xiaoming, SHU Yan. Nursing care for a patient with ultra-short bowel syndrome and multiple stomas after surgery for allied disorders of Hirschsprung’s disease [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 849-851.
[10]	SHAO Lihong, LI Chunyan, DONG Xiaoqi, WANG Qiaolin, YE Guofeng, ZHAO Qiaomei. Nursing care for multiple severe complications after free flap transplantation in a patient with oral multiple primary cancer [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 852-855.
[11]	ZHANG Hui, HE Xuehua, WANG Li, GONG Xiaoyan, ZHUANG Yiyu. Early warning and nursing intervention for primary graft dysfunction after heart transplantation using a marginal donor heart：a case report [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 682-684.
[12]	ZENG Fei. Nursing care of a patient with familial hypertrophic cardiomyopathy complicated with liver failure undergoing simultaneous heart-liver transplantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 685-688.
[13]	YANG Muying, FAN Wenqi, HU Han. Early identification and emergency nursing of cerebral hemorrhage during dialysis in a maintenance hemodialysis patient [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 704-706.
[14]	ZHUANG Jiani, LI Xiaozhen, SHI Chaoqiang, WANG Ying, TAN Liping. Perioperative nursing care for a patient with malignant mediastinal abscess secondary to deep neck infection [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 707-709.
[15]	LI Gaile, PAN Wenyan, LI Jingjing, LIU Xiao, TANG Yingjia, HOU Jin. Nursing care of a post-liver transplantation patient complicated with pneumocystis jirovecii and cytome-galovirus infection [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(6): 710-713.

Nursing care for one case of systemic sclerosis treated with chimeric antigen receptor T-cell complicated with cytokine release syndrome

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References 11

Related Articles 15

Recommended Articles

Metrics

Comments