13例含利妥昔单抗化疗方案致药物性肺损伤分析

目的:总结和分析含利妥昔单抗化疗方案所致肺损伤,初步探讨其规律并指导临床。方法:对某院血液科2007年7月－2013年7月使用含利妥昔单抗化疗方案并发生肺损伤13例淋巴瘤患者的临床特征、影像学表现、发病时间、治疗效果及预后进行分析。结果:主要症状为发热、呼吸困难、咳嗽;9例患者血气提示低氧血症,其中6例为I型呼吸衰竭;胸部CT主要表现为斑片状磨玻璃影、网格状模糊影及小叶间隔增厚;所处化疗疗程主要分布在2~4疗程,症状出现距方案中利妥昔单抗输注时间主要在13~22 d;13例患者激素治疗均有效,治疗好转痊愈后大部分患者生活质量无影响。结论:含利妥昔单抗化疗方案导致的肺损伤早期发现及早期激素治疗可以取得好的治疗效果,对其发生规律及临床特点的探寻仍需进一步累计病例。

Analysis of 13 cases of lung injuries resulted by rituximab containing chemotheray

OBJECTIVE To summarize and analyze lung injuries resulted by rituximab containing chemotherapy, and primary investigate its mechanism to direct clinical use. METHODS The clinical features, laboratory examination, chemotheray regimen were collected from 13 patients received rituximab containing chemotheray. The clinical characteristics, therapeutic effects and prognosis of patients were retrospectively analyzed from July 2007 to July 2013. RESULTS The main symptoms were fever, dyspnea and cough; patchy ground glass opacity, grid fuzzy shadows and interlobular septal thickening were shown in CT scans; most patients were in cycle 2－4 and the time from the rituximab infusion to onset of respiratory manifestations were mostly 13－22 days; 13 cases were all cured, and the quality of life in most patients was not affected. CONCLUSION The rituximab containing chemotherapy can induce lung injury, but early diagnosis and early hormonal treatment can obtain good therapeutic effects. The occurrence regularity and clinical characteristics should be studied in future.