目的：通过对比免疫相关不良反应（irAE）发生前后血常规中主要指标的变化，为鉴别诊断irAE 及感染性炎症提供新依据。方法：回顾性分析201 例2018 年8月至2022 年6月在河南省肿瘤医院接受抗PD-1抗体治疗后出现irAE 的肿瘤患者的临床资料，包括抗PD-1抗体治疗前、发生irAE前及irAE后血常规的主要指标，采用配对t检验分析治疗前后血常规指标值的统计学差异。采用定性变量的配对c2检验分析治疗前后血常规指标值的阳性率（高于正常值的比例）的统计学差异。结果：从201 例患者中观察到了258 次irAE，其中27 例（13.4%）患者发生了2种及以上类型的irAE，214 次（82.94%）irAE 未引起发热；irAE 发生后与抗PD-1抗体治疗前相比，白细胞计数（t=1.087, P=0.278）、中性粒细胞计数（t=0.959, P=0.338）及中性粒细胞百分比（t=0.817，P=0.414）未见明显升高，且三指标高于正常值的病例数分别为28 vs 38（χ2=1.737，P=0.187）、32 vs 44（χ2=2.222，P=0.136）、45 vs 55（χ2=1.240，P=0.265）,差异均无统计学意义。结论：irAE 发生后患者外周血白细胞计数、中性粒细胞计数及中性粒细胞百分比无明显变化，这对鉴别诊断感染性炎症可能具有参考意义。

Objective: To provide a new basis for the differential diagnosis of immune-related adverse events (irAEs) and infectious inflammation by comparing the changes of the main indicators in blood routine examination before and after the occurrence of irAEs.Methods: The clinical data of 201 patients with malignant tumors who had irAEs after receiving anti-PD-1 antibody therapy in Henan Cancer Hospital between August 2018 and June 2022 were retrospectively analyzed. The main indicators of blood routine examination before anti-PD-1 antibody treatment, before and after irAEs were collected. The statistical differences of blood routine index values before and after treatment were analyzed by paired t-test. Chi-square test was used to analyze the statistical difference in the positive rate (the proportion of blood routine index values above normal) before and after treatment. Results: 258 irAEs were observed in the 201 patients, of which 27 (13.4%) developed 2 or more types of irAEs, and 214 (82.94%) irAEs did not cause fever; The white blood cell count (t=1.087, P=0.278), neutrophil count (t=0.959, P=0.338) and neutrophil percentage (t=0.817, P=0.414) did not increase significantly after irAEs compared with those before anti-PD-1 antibody treatment. The numbers of cases above the normal value were 28 vs 38 (χ2=1.737, P=0.187), 32 vs 44 (χ2=2.222, P=0.136), 45 vs 55 (χ2=1.240, P=0.265), and the differences were not statistically significant. Conclusion: After the occurrence of irAEs, there were no significant changes in peripheral blood white blood cell count, neutrophil count and neutrophil percentage, which may be of reference significance for the differential diagnosis of infectious inflammation.