利妥昔单抗注射液联合CHOP方案对非霍奇金淋巴瘤患者血清LDH、β2-MG水平的影响

The effect of rituximab injection combined with CHOP regimen on serum LDH andβ2-MG levels in patients with non Hodgkin′s lymphoma

目的研究利妥昔单抗注射液联合环磷酰胺+表柔比星+长春新碱+泼尼松(CHOP)方案对非霍奇金淋巴瘤(NHL)患者血清乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)水平的影响。方法选取2020年1月至2023年5月阜阳市人民医院血液内科收治确诊的92例NHL患者,以随机数字表法分为观察组(n=46)与对照组(n=46)。对照组采用CHOP方案给予化疗干预;观察组在CHOP方案化疗开始前1 d静脉滴注利妥昔单抗注射液。连续治疗6周期(1周期为21 d),比较两组疗效及不良反应,治疗后炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]、T淋巴细胞[表面抗原分化簇4(CD4^(+))、表面抗原分化簇8(CD8^(+))、CD4/CD8、辅助性T细胞17(Th17)]、血管内皮生长因子(VEGF)、LDH及β2-MG水平。结果观察组总缓解率80.43%(37/46)高于对照组60.87%(28/46),差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后TNF-α、IL-6水平降低,Th17及CD8^(+)水平升高,差异有统计学意义(均P<0.05);且治疗后观察组TNF-α、IL-6水平低于对照组,Th17水平高于对照组,差异有统计学意义(均P<0.05)。与治疗前比较,两组治疗后LDH、β2-MG、VEGF水平降低,差异有统计学意义(均P<0.05);且治疗后观察组LDH、β2-MG、VEGF水平低于对照组,差异有统计学意义(均P<0.05)。两组不良反应总发生率分别为86.96%(40/46)、80.43%(37/46),差异无统计学意义(P>0.05)。结论利妥昔单抗注射液联合CHOP方案用于NHL治疗可有效缓解患者炎症反应,改善LDH、β2-MG、VEGF水平,提升疗效,安全性与单独使用CHOP方案相差无几,值得推广应用。

Objective To investigate the effect of the combination of rituximab injection and cyclophosphamide+hydroxydoxorubicin+oncovin+prednisone(CHOP)regimen on serum lactate dehydrogenase(LDH)andβ2-microglobulin(β2-MG)levels in patients with non Hodgkin′s lymphoma(NHL).Methods A total of 92 NHL patients admitted to the Hematology Department of Fuyang People′s Hospital from January 2020 to May 2023 were selected and randomly divided into an observation group(n=46)and a control group(n=46)using a random number table method.The control group received chemotherapy intervention with CHOP regimen;The observation group received intravenous infusion of rituximab injection 1 day before the start of CHOP chemotherapy.After 6 consecutive cycles of treatment(1 cycle for 21 days),the efficacy and adverse reactions,the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],T lymphocytes[surface antigen differentiation cluster 4(CD4^(+)),surface antigen differentiation cluster 8(CD8^(+)),CD4/CD8,helper T cells 17(Th17)],vascular endothelial growth factor(VEGF),LDH,andβ2-MG of the two groups were compared after treatment.Results The total remission rate of the observation group was 80.43%(37/46),which was higher than that of the control group,which was 60.87%(28/46),and the difference was statistically significant(P<0.05).Compared with before treatment,TNF-αand IL-6 levels decreased,Th17 and CD8^(+)levels increased in both groups after treatment,and the difference was statistically significant(all P<0.05);After treatment,the TNF-αand IL-6 levels in the observation group were lower than those in the control group,and Th17 levels were higher than those in the control group,with statistically significant differences(all P<0.05).Compared with before treatment,the LDH,β2-MG,and VEGF levels in the two groups decreased significantly after treatment(all P<0.05);After treatment,the LDH,β2-MG,and VEGF levels in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The total incidence rates of adverse reactions in the two groups were 86.96%(40/46)and 80.43%(37/46),respectively,with no statistically significant difference(P>0.05).Conclusions The combination of rituximab injection and CHOP regimen for NHL treatment can effectively alleviate inflammation,improve LDH,β2-MG,VEGF levels,and enhance efficacy.The safety is similar to using CHOP regimen alone,and it is worth promoting and applying.