CAJ | 학술논문

[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。
[목적]탐토소제량리타석단항연합삼맥주사액치료노년용혈성빈혈적료효급안전성。[방법]이32례노년자신면역성용혈성빈혈（autoimmune hemolytic anemia ,AIHA）환자위연구대상，20례급여발니송1mg/（kg·d）위상규조，4주후관찰료효。12례인합병각충질병불능사용격소치료，급여리타석단항위치료조，리타석단항매차100 mg，매주1차，련용4차，동시급우삼맥주사액60mL/d，료정2주（제1~14d），4주후관찰료효。[결과]20례상규격소치료환자중，완전완해4례，부분완해12례，무효4례，완전완해솔20.0%，총유효솔80.0%。12례급여소제량리타석단항연합삼맥주사액치료환자중，완전완해6례，부분완해5례，무효1례，완전완해솔50.0%，총유효솔91.6%。치료조완전완해솔급유효솔명현고우상규조,차이유통계학의의（P＜0.05）。[결론]소제량리타석단항연합삼맥주사액치료노년AIHA환자유효성、안전성균우우상규격소치료，치득진일보연구。
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·kg-1·d-1 for 4 weeks and 12 cases ineligible for glucocorticoid receiving rituximab(100mg/week for 4 times) combined with Shenmai Injection 60ml ·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.