利妥昔单抗致肺损伤五例及文献复习  

Rituximab-Induced Lung Injury:Five Cases Report and Literature Review

作　　者：刘一[1] 胡小龙[1] 王东[1] 张波[1] 

机构地区：[1]空军总医院呼吸科,北京100142

出　　处：《中国呼吸与危重监护杂志》2012年第3期262-266,共5页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的提高对利妥昔单抗导致肺损伤的认识。方法对5例淋巴瘤患者接受利妥昔单抗化疗后导致肺损伤的临床资料进行分析。结果 5例患者均接受了含利妥昔单抗方案的化疗,分别在化疗3～5个疗程后出现发热、咳嗽或呼吸困难,胸部CT表现为弥漫性间质病变。5例患者均有不同程度的低氧血症或呼吸衰竭,通过糖皮质激素治疗,3～5 d临床症状明显改善,1～2周肺部病变明显吸收好转。复习文献,利妥昔单抗导致肺损伤的发生率为0.03%～4.9%,近年有增加趋势。结论随着利妥昔单抗的广泛应用,利妥昔单抗导致的肺损伤已非罕见,提高对本病的认识,早诊断、早治疗是决定患者预后的关键。Objective To improve the knowledge of lung injury induced by rituximab.Methods Clinical data of 5 lymphoma patients with lung injury caused by rituximab chemotherapy were analyzed.Results Five patients received chemotherapy including rituximab,and had fever,cough and dyspnea after 3 to 5 chemotherapy cycles.Chest CT showed bilateral diffuse interstitial infiltrates.All 5 cases experienced hypoxemia or respiratory failure.Clinical symptoms were improved 3 to 5 days after the treatment of glucocorticoids,and pulmonary lesions were significantly alleviated 1 to 2 weeks after the treatment.According to the literature,the incidence rate of lung injury caused by rituximab was 0.03% to 4.9%,which has increased recently.Conclusions With the comprehensive application of rituximab,lung injury caused by this drug is not rare.The good prognosis depends on early diagnosis and treatment by further recognition of the side effect of rituximab.

关 键 词：利妥昔单抗 肺损伤 药物不良反应 

分 类 号：R733.1[医药卫生—肿瘤]