目的 探讨利妥昔单抗在治疗弥漫大B细胞淋巴瘤中的应用价值.方法 2008年2月到2014年6月选择在安康市中心医院进行诊治的弥漫大B细胞淋巴瘤患者81例,根据随机数字表法,将患者分为两组,治疗组41例,对照组40例,对照组患者给予CHOP方案进行化疗,治疗组在对照组基础上给予利妥昔单抗治疗.观察两组的临床疗效;所有患者随访至2015年6月,观察与记录两组的无进展生存期与总生存期;观察两组在治疗期间出现的毒副反应情况,主要包括骨髓抑制、消化道反应、神经系统毒性、血液系统毒性等.结果 治疗组的有效率(78.0%)明显高于对照组(50.0%)(P <0.05).治疗期间治疗组的骨髓抑制、消化道反应、神经系统毒性、血液系统毒性等毒副反应情况明显少于对照组(P <0.05).治疗组的无进展生存期与总生存期分别为(22.34±2.11)月和(33.14±3.19)月,而对照组分别为16.23±1.98个月和24.45±3.15个月,治疗组的无进展生存期与总生存期都明显多于对照组(P <0.05).治疗期间治疗组的骨髓抑制、消化道反应、神经系统毒性、血液系统毒性等毒副反应情况明显少于对照组(P <0.05).结论 利妥昔单抗在治疗弥漫大B细胞淋巴瘤中能提高治疗总体疗效与总体生存期,应用安全性较好,值得在临床上推广使用.

Objective To investigate the application value of rituximab in treatment of diffuse large B-cell lymphoma. Methods From February 2008 to June 2014 in the Center Hospital of Ankang City, 81 diffuse large B-cell lymphoma patients were selected, and equally divided into treatment group of 41 patients and control group of 40 patients according to a random number table. The patients in the control group received chemotherapy with CHOP, and the patients in the treatment group received rituximab treatment on the basis of the control group. To observe the clinical efficacy of the two groups, all patients were followed up until June 2015, the progress in survival and overall survival of the two groups and the toxic and side effects including bone marrow suppression, gastrointestinal reaction, nervous system toxicity, blood system toxicity, etc were observed during the treatment,. Results The effective rates in the treatment and control groups were 78.0% and 50.0% that the treatment group had significantly higher effective rate (P <0.05). The bone marrow suppression, gastrointestinal reactions, nervous system toxicity, hematologic toxicity, and other adverse reactions in the treatment group during treatment were significantly less than those in the control group (P <0.05). All patients were followed until June 2015. The progression-free survival and overall survival time in the treatment group were (22.34 ± 2.11) and (33.14 ± 3.19) months, while those in the control group were (16.23 ± 1.98) and (24.45 ± 3.15) months that the treatment group were significantly more than the control group (P <0.05). In the treatment group, the toxicity of the bone marrow suppression, digestive tract reaction, nervous system toxicity, blood system toxicity, and other adverse reactions in the treatment group was significantly less than those in the control group (P <0.05). Conclusion Rituximab treatment in diffuse large B-cell lymphoma can improve overall treatment efficacy and overall survival, but also has very good application security that should be introduced in clinical practice.