利妥昔单抗注射液在老年非霍奇金淋巴瘤患者中的临床应用

Application value of rituximab injection in elderly patients with non-Hodgkin lymphoma

目的探讨利妥昔单抗注射液对老年非霍奇金淋巴瘤(NHL)的疗效和安全性,评价其对患者免疫功能等的影响。方法根据治疗方法的不同将80例NHL分为观察组和对照组,每组40例,观察组患者接受化疗联合利妥昔单抗注射液治疗,对照组患者仅接受化疗。比较两组患者的临床疗效、不良反应、治疗前后免疫指标[免疫球蛋白G(IgG)、IgA、IgM、补体3(C3)、C4]及[胸腺嘧啶脱氧核甘激酶-1(TK-1)、血管内皮生长因子(VEGF)、乳酸脱氢酶(LDH)]。结果观察组患者临床总有效率为70.0%(28/40),高于对照组患者的47.5%(19/40),差异有统计学意义(P﹤0.05)。治疗后,两组患者IgG、IgA、IgM、C3、C4、TK-1、VEGF和LDH水平均低于本组治疗前,且观察组患者C3、C4、TK-1、VEGF和LDH水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者均未出现过敏反应和心律失常,治疗期间白细胞减少、恶心呕吐、肝功能损害和脱发发生率的比较,差异均无统计学意义(P﹥0.05)。结论利妥昔单抗注射液联合化疗治疗老年NHL患者疗效显著,可明显抑制肿瘤增殖和侵袭性,保护免疫系统,且无严重不良反应。

Objective To investigate the efficacy and safety of rituximab injection in elderly patients with non-Hodgkin lymphoma(NHL),and to assess its effect on immune function and quality of life of patients.Method Eighty elderly patients with NHL were categorized as study group or control group according to different treatment methods administered,with 40 cases in each,the study group was treated with rituximab injection combined with chemotherapy,while the control group was administered with chemotherapy alone.The efficacy,adverse reactions,immune indicators[immunoglobulin G(IgG),IgA,IgM,C3,C4,thymidine kinase-1(TK-1),vascular endothelial growth factor(VEGF),and lactate dehydrogenase(LDH)]before and after treatment were compared between the two groups.Result The response rate in study group was 70.0%(28/40),and was higher than the 47.5%(19/40)in control group,the difference was statistically significant(P<0.05).After treatment,the levels of IgG,IgA,IgM,C3,C4,TK-1,VEGF,and LDH were all decreased in both groups,furthermore,the levels of C3,C4,TK-1,VEGF and LDH in study group were significantly lower compared to control group(P<0.05).Absence of hypersensitivity or arrhythmia were confirmed in both groups,additionally,there were no significant differences in regard to the incidences of leukopenia,nausea and vomiting,liver function damage and alopecia between the two groups(P>0.05).Conclusion Rituximab injection combined with chemotherapy is remarkably useful in the treatment of elderly patients with non-Hodgkin lymphoma,with evident suppression on tumor proliferation and invasion,protecting the immune system and may not induce serious adverse reactions.