非霍奇金淋巴瘤予含利妥昔单抗化疗后卡氏肺孢子虫肺炎2例报告并文献复习  

Pneumocystis carinii pneumonia-in patients with non-Hodgkin's lymphoma after rituximab-containing regimen:two cases of report and literature review

作　　者：沈晶[1] 付丽[1] 魏娜[1] 黄达永[1] 王昭[1] 

机构地区：[1]首都医科大学附属北京友谊医院血液内科,北京100050

出　　处：《临床和实验医学杂志》2016年第21期2167-2170,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨非霍奇金淋巴瘤予含利妥昔单抗化疗与卡氏肺孢子虫肺炎的相关性。方法研究报告2例含利妥昔单抗化疗后确诊卡氏孢子虫肺炎病例,并结合文献进行分析。结果 2例患者临床表现为发热、干咳、气短,迅速出现急性呼吸窘迫综合征,胸部CT表现为两肺弥漫性毛玻璃阴影,治疗主要依靠大剂量复方磺胺甲基异恶唑伴或不伴卡泊芬净。结论对免疫力低下患者,尤其非霍奇金淋巴瘤予含利妥昔单抗化疗后出现快速进展的低氧血症应警惕卡氏肺孢子虫肺炎,早期诊断、早期治疗和合理预防是治疗此病的关键。Objective Rituximab could enhance the efficacy and improve the prognosis in the treatment of non - Hodgkin＇s lymphoma. Meanwhile it could increase the opportunity of lung infection because of its immunosuppression effects. To explore the relationship between remedy containing rituximab and Pneumocystis jiroveci pneumonia （ PCP）, a rare opportunistic infection. Methods Two cases of PCP after rituximab - containing regimen were reported and the literatures were also reviewed. Results Two reported patients were presented with aeute fever with dry cough ,shortness of breath,progressive hypoxia and diffuse ground -glass shadows on chest CT scanning films. PCP were treated with high dosage trimethoprim - sulfamethoxazole with or without caspofungin. Conclusion One should be alert to the oceurrence of PCP when hypoimmunity pa- tients with rapidly progressive hypoxemia, early diagnosis and treatment rational prophylaxis are the key to improve survival in these patients.

关 键 词：非霍奇金淋巴瘤 利妥昔单抗 肺炎 卡氏肺孢子虫 

分 类 号：R733.1[医药卫生—肿瘤] R531.5[医药卫生—临床医学]