新冠肺炎康复者血浆治疗非霍奇金淋巴瘤化疗后并发新冠肺炎3例效果  

Effect of convalescent plasma therapy on treatment of 3 non-Hodgkin lymphoma patients complicated with COVID-19 after chemotherapy

作　　者：姬涛[1] 宋玉祥[2] 张恒[1] 龚汉普 于金习 刘刚[1] 朱海燕[1] 翟永志[1] JI Tao;SONG Yu-xiang;ZHANG Heng;GONG Han-pu;YU Jin-xi;LIU Gang;ZHU Hai-yan;ZHAI Yong-zhi(The First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心急诊医学科,北京100853 [2]解放军总医院第一医学中心麻醉科,北京100853

出　　处：《中华医院感染学杂志》2024年第2期191-195,共5页Chinese Journal of Nosocomiology

基　　金：海南省重大科技计划基金资助项目(ZDKJ202004);军队重点学科-战创伤外科学拔尖人才培养基金资助项目(2021)。

摘　　要：目的评价新冠肺炎康复者血浆治疗非霍奇金淋巴瘤(NHL)利妥昔单抗化疗后并发新冠肺炎的有效性。方法回顾性分析解放军总医院第一医学中心发热门诊于2023年2月1日—2月28日收治的3例接受新冠肺炎康复者血浆治疗的非霍奇金淋巴瘤利妥昔单抗化疗后并发新冠肺炎患者的临床资料,记录患者的性别、年龄、基础疾病、发病至输血时间、发病至新冠病毒核酸转阴时间、治疗时间、输血次数和输血量,白细胞计数(WBC)、C-反应蛋白(CRP)、白细胞介素6(IL-6)等实验室检查结果和肺部影像学结果。结果3例患者中,男性2例,女性1例;年龄分别为53岁,55岁,60岁;入院新冠病毒核酸均阳性,新冠抗体阴性,肺部感染明确;均于入院后第3天,在标准治疗的基础上,分别予以输入康复者血浆14次(共计6640 ml)、10次(共计4340 ml)、2次(共计780 ml),输入血浆第14天、第4天、第2天后新冠核酸检测呈阴性;核酸转阴后患者体温逐渐恢复至正常范围,WBC、C RP、IL-6水平在输注血浆后逐渐升高,待新冠核酸转阴后水平逐渐下降至正常;复查肺部CT提示较前明显吸收;3例患者分别在院治疗30 d、15 d、16 d后出院,随访3个月病情无反复。结论对于非霍奇金淋巴瘤利妥昔单抗化疗后并发新冠肺炎患者,在标准治疗的基础上,使用新冠肺炎康复者血浆疗法会对此类特殊患者的康复起到积极作用,也为临床治疗提供了更多的选择。OBJECTIVE To evaluate the effectiveness of convalescent plasma therapy in treatment of the non-Hodgkin lymphoma(NHL)patients with COVID-19 after rituximab chemotherapy.METHODS The clinical data were collected from 3 NHL patients who received convalescent plasma therapy and had COVID-19 after rituximab chemotherapy in fever clinic of the First Medical Center of Chinese PLA General Hospital from Feb 1,2023 to Feb 28,2023.The gender,age,underlying diseases,time interval between onset and blood transfusion,time interval between onset and SARS-CoV-2 nucleic acid turning to be negative,treatment time,number of times of blood transfusion and blood transfusion volume were recorded;the results of laboratory tests for white blood cell(WBC)counts,C-reactive protein(CRP)and interleukin-6(IL-6)as well as the lung imaging findings were observed.RESULTS Among the 3 patients,2 patients were male,and 1 patient was female;they were 53 years old,55 years old and 60 years old,respectively;the 3 patients were respectively with SARS-CoV-2 nucleic acid tested positive at the ad-mission to the hospital,CO VID-19 antibody tested negative,and clear pulmonary infection.The 3 patients were respec-tively given intravenous infusion of convalescent plasma for 14 times(6640 ml in total),10 times(4340ml in total)and 2 times(780 ml in total)on basis of the standard treatment after the admission for 3 days.The SARS-CoV-2 nucleic acid was tested negative after the convalescent plasma therapy for 14,4 and 2 days;the body temperature gradually returned to normal range after the nucleic acid was tested negative,the levels of WBC,CRP and IL-6 rose gradually after the infu-sion of plasma and gradually declined to normal ranges after the SARS-CoV-2 nucleic acid turned to be negative.The CT image of the lungs indicated that the pneumonia was absorbed obviously.The 3 patients were respectively discharged after they were hospitalized for treatment for 30,15 and 16 days,and a 3-month follow-up showed that there was no case of recurrence.CONCLUSION The conval

关 键 词：非霍奇金淋巴瘤 利妥昔单抗 新冠肺炎 新冠肺炎康复者血浆 疗效 

分 类 号：R730.5[医药卫生—肿瘤]