摘要
目的评价利妥昔单抗注射液联合CHOP方案(环磷酰胺+多柔比星+长春新碱+泼尼松龙)治疗弥漫性大B细胞淋巴瘤(DLBCL)患者的临床疗效。方法前瞻性选择新疆医科大学第一附属医院2019年6月至2022年6月收治的120例DLBCL患者为研究对象,按随机数字表法分为研究组和对照组,每组60例,对照组予以CHOP方案治疗,研究组在CHOP方案基础上联合利妥昔单抗注射液治疗。6个疗程后评估两组临床疗效,比较两组治疗前后炎性因子及免疫功能指标变化,比较两组治疗后不良反应发生情况。结果研究组治疗后临床总有效率高于对照组[88.33%(53/60)比70.00%(42/60)],差异有统计学意义(χ^(2)=6.11,P<0.05)。两组治疗前血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)比较差异无统计学意义(P>0.05);两组治疗后血清IL-6、TNF-α水平均降低,并且研究组治疗后血清IL-6、TNF-α水平低于对照组[(223.56±21.28)ng/L比(267.35±25.36)ng/L、(9.34±2.75)μg/L比(11.96±3.83)μg/L],差异有统计学意义(P<0.05)。两组治疗前血清免疫球蛋白(Ig)A、IgM、IgG比较差异无统计学意义(P>0.05)。两组治疗后IgA、IgM及IgG均不同程度降低,研究组治疗后血清IgA、IgM、IgG高于对照组[(1.83±0.46)g/L比(1.34±0.34)g/L、(1.15±0.22)g/L比(0.83±0.24)g/L、(10.67±1.65)g/L比(8.02±1.62)g/L],差异有统计学意义(P<0.05)。研究组治疗后血小板减少、白细胞降低、胃肠道反应、骨髓抑制、肝功能损伤发生率均低于对照组[6.67%(4/60)比20.00%(12/60)、15.00%(9/60)比31.67%(19/60)、30.00%(18/60)比58.33%(35/60)、5.00%(3/60)比16.67%(10/60)、10.00%(6/60)比25.00%(15/60)],差异有统计学意义(χ^(2)=4.62、4.66、9.77、4.33、4.88,P<0.05)。结论针对DLBCL以利妥昔单抗注射液联合CHOP方案治疗效果显著,可减轻患者机体炎性反应,减少对机体免疫功能的损害,降低化疗引起的不良反应。
Objective To evaluate the clinical efficacy of rituximab injection combined with CHOP regimen(cyclophosphamide+doxorubicin+vincristine+prednisolone)in the treatment of diffuse large B-cell lymphoma(DLBCL).Methods One hundred and twenty patients with DLBCL who treatment in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to June 2022 were selected as the study object.They were randomly divided into the study group(60 cases)and the control group(60 cases).The control group was treated with CHOP regimen,and the study group was treated with rituximab injection on the basis of CHOP regimen.The clinical efficacy,inflammatory reaction,immune function and adverse reaction were evaluated after 6 courses of treatment.Results After treatment,the total clinical effective rate in the study group was higher than that in the control group:88.33%(53/60)vs.70.00%(42/60),there was statistical difference(χ^(2)=6.11,P<0.05).Before treatment,the levels of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups had no significant differences(P>0.05);after treatment,the levels of serum IL-6 and TNF-αwere decreased,and the levels of serum IL-6 and TNF-αin the study group were lower than those in the control group:(223.56±21.28)ng/L vs.(267.35±25.36)ng/L,(9.34±2.75)μg/L vs.(11.96±3.83)μg/L,there were statistical differences(P<0.05).Before treatment,the levels of serum immunoglobulin(Ig)A,IgM and IgG in the two groups had no significant differences(P>0.05);after treatment,the levels of serum IgA,IgM and IgG were decreased,but the levels of serum IgA,IgM and IgG in the study group were higher than those in the control group:(1.83±0.46)g/L vs.(1.34±0.34)g/L,(1.15±0.22)g/L vs.(0.83±0.24)g/L,(10.67±1.65)g/L vs.(8.02±1.62)g/L,there were statistical differences(P<0.05).After treatment,the incidence of thrombocytopenia,leucopenia,gastrointestinal reaction,bone marrow suppression and liver function injury in the study group were lower than those in the control group:6.67%(4/60)vs.20.00%(12/60),15.00%(9/60)vs.31.67%(19/60),30.00%(18/60)vs.58.33%(35/60),5.00%(3/60)vs.16.67%(10/60),10.00%(6/60)vs.25.00%(15/60),there were statistical differences(χ^(2)=4.62,4.66,9.77,4.33,4.88,P<0.05).Conclusions The treatment effect of rituximab injection combined with CHOP regimen in DLBCL is significant,which can reduce the inflammatory reaction of the body,reduce the damage of immune function,and reduce the adverse reactions of chemotherapy.
作者
尹珍珍
韩春霞
袁海龙
Yin Zhenzhen;Han Chunxia;Yuan Hailong(Department of Hematology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《中国医师进修杂志》
2024年第2期102-106,共5页
Chinese Journal of Postgraduates of Medicine
基金
新疆维吾尔自治区自然科学基金(2017D01C297)。
