摘要
[目的]探讨小剂量利妥昔单抗联合参麦注射液治疗老年溶血性贫血的疗效及安全性。[方法]以32例老年自身免疫性溶血性贫血（autoimmune hemolytic anemia ,AIHA）患者为研究对象，20例给予泼尼松1mg/（kg·d）为常规组，4周后观察疗效。12例因合并各种疾病不能使用激素治疗，给予利妥昔单抗为治疗组，利妥昔单抗每次100 mg，每周1次，连用4次，同时给于参麦注射液60mL/d，疗程2周（第1-14d），4周后观察疗效。[结果]20例常规激素治疗患者中，完全缓解4例，部分缓解12例，无效4例，完全缓解率20.0%，总有效率80.0%。12例给予小剂量利妥昔单抗联合参麦注射液治疗患者中，完全缓解6例，部分缓解5例，无效1例，完全缓解率50.0%，总有效率91.6%。治疗组完全缓解率及有效率明显高于常规组,差异有统计学意义（P＜0.05）。[结论]小剂量利妥昔单抗联合参麦注射液治疗老年AIHA患者有效性、安全性均优于常规激素治疗，值得进一步研究。
Objective] To explore the safety and efficacy of lower dose of rituximab combined with Shenmai Injection in the treatment of elderly autoimmune hemolytic anemia（AIHA）. [Methods] From May 2008 to February 2014, a total of 32 patients with newly diagnosed elderly AIHA patients were enrol ed in the study, including 20 cases treated with prednisone 1mg＆#183;kg-1＆#183;d-1 for 4 weeks and 12 cases ineligible for glucocorticoid receiving rituximab（100mg/week for 4 times） combined with Shenmai Injection 60ml ＆#183;d -1 for two weeks. [Results]Of the 20 patients with conventional glucocorticoid, 4 cases（20.0%） had complete remission（CR）, 12 cases with partial remission（PR） and 4 cases without response, 5 cases with secondary pulmonary infection. The overal response rate was 80.0%, the secondary infection rate was 25%. Of the 12 cases with rituximab combined with Shenmai Injection, 6 cases（50.0%） were CR, 5 cases with PR and 1 without response, 0 case with secondary infection. The overal response rate was 91.6%, the secondary infection rate was 0. A significantly higher CR rate and lower secondary infection rate were seen in rituximab combined with Shenmai Injection, as compared with that in conventional glucocorticoid（P=0.038）. [Conclusion] A lower dose of rituximab combined with Shenmai Injection, with satisfactory safety and efficacy, was better than the conventional glucocorticoid in the treatment of elderly AIHA patients.
出处
《浙江中医药大学学报》
CAS
2014年第10期1186-1187,1191,共3页
Journal of Zhejiang Chinese Medical University
关键词
老年人
利妥昔单抗
参麦注射液
AIHA
autoimmune hemolytic anemia
elderly persons
rituximab
Shenmai Injection
