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目的:观察利妥昔单抗与CHOP化疗联合治疗感染乙肝病毒(HBV)的非霍奇金淋巴瘤(NHL)患者的有效性及安全性。方法:选取2010年6月至2013年6月35例B细胞NHL住院患者,分为两组,观察组(n=13)为感染HBV患者,接受利妥昔单抗-CHOP化疗方案;对照组(n=22)为非感染HBV的患者,单纯接受CHOP化疗方案,两组治疗4~6疗程,观察两组患者治疗的疗效及肝功能。结果:观察组完全缓解率(CR率)为76.92%,对照组CR率为40.91%(P<0.05),两组差异有统计学意义。观察组肝功能损害I~Ⅱ级发生率为23.07%,对照组肝功能损害I~Ⅱ级发生率18.18%(P>0.05),观察组毒副反应发生率为30.77%,对照组毒副反应发生率为22.72%(P>0.05),两组在肝功能损害及毒副反应上差异无统计学意义。两组患者HBV均未再激活。结论:感染HBV的B细胞NHL患者用R-CHOP联合化疗方案治疗,以及在化疗时预防性、足疗程的抗病毒治疗,可以减少HBV再激活的发生,并且可以降低肝功损害率。
Objective: To observe the efficacy and safety of rituximab in combination with CHOP chemotherapy in the treatment of non-Hodgkin’s lymphoma (NHL) infected with hepatitis B virus. Methods: Thirty-five patients with NHL admitted to B cell from June 2010 to June 2013 were enrolled in this study. Patients in the observation group (n = 13) were infected with HBV and received rituximab-CHOP chemotherapy. In the control group (n = 22) were non-infected HBV patients, receiving CHOP chemotherapy alone. The two groups were treated for 4 to 6 courses of treatment. The curative effect and liver function of the two groups were observed. Results: The CR rate was 76.92% in the observation group and 40.91% in the control group (P <0.05). The difference between the two groups was statistically significant. The incidence of grade I ~ II liver injury in observation group was 23.07%, the incidence of grade I ~ II liver damage in control group was 18.18% (P> 0.05), and the incidence of toxic and side reaction in observation group was 30.77% The incidence was 22.72% (P> 0.05). There was no significant difference between the two groups in liver damage and toxicity. HBV in both groups was not reactivated. CONCLUSIONS: Treatment with B-cell NHL in patients infected with HBV with R-CHOP combined with chemotherapy and prophylactic, full-course antiviral therapy during chemotherapy can reduce HBV reactivation and reduce the rate of liver damage.