摘要
1例71岁男性患者因弥漫大B细胞淋巴瘤拟行利妥昔单抗375 mg/m^2联合CHOP（环磷酰胺750 mg/m^2、吡柔比星50 mg/m^2、长春新碱2 mg,D1,iv,醋酸泼尼松片D1-D5,po）方案化疗。第二周期化疗结束后8天,患者出现发热、咳嗽、呼吸困难等症状,经验性使用抗菌药物治疗无效,结合相关实验室检查及肺部影像学特征,诊断为间质性肺炎。考虑为利妥昔单抗致间质性肺炎。停止使用可疑药物同时给予醋酸泼尼松30 mg,bid,5天后临床症状明显改善,10天后复查肺部CT双肺病变明显吸收,剂量调整为醋酸泼尼松20 mg,qd,1个月后胸部CT显示双肺病变完全消失,肺功能测试在正常范围内。将醋酸泼尼松逐渐减量使用,换用CHOP方案继续化疗,未再引起间质性肺炎。
A 71-year-old male patient with diffuse large B cell lymphoma received a chemotherapy by rituxan375 mg/m^2 combined with CHOP（cyclophosphamide 750 mg/m^2, pirarubicin 50 mg/m^2, vincristine 2 mg, iv, D1,prednisone acetate tablets D1- D5, po）. Eight days after the second cycle of chemotherapy, the patient experienced symptoms such as fever, cough and dyspnea, in which empirical use of antimicrobial drug treatment is ineffective. The disease was diagnosed as interstitial pneumonia by the symptoms combined with relevant laboratory tests and lung imaging features, which was considered to be caused by rituxan. The symptoms were improved significantly 5 d, while the review of lung CT showed that the inflammation of double lungs were absorbed significantly 10 d, after withdrawal of the doubtful drugs and treatment with 30 mg prednisone acetate, bid. However,the chest CT showed that the lesions of double lungs disappeared one month after the dose of prednisone acetate was adjusted to 20 mg, qd, while the pulmonary function test result was within the normal range. No interstitial pneumonia was caused after chemotherapy by an improved CHOP protocol in prednisone acetate was at a gradually decreased dosage.
出处
《中国执业药师》
CAS
2016年第8期48-50,共3页
China Licensed Pharmacist
