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赵洁.后疫情时代芦可替尼对血液病患者合并新型冠状病毒感染疗效的真实世界研究[J].内科急危重症杂志,2025,31(2):135-139
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| DOI：10.11768/nkjwzzzz20250208 |
| 中文关键词: 芦可替尼 血液病 新型冠状病毒肺炎 重症肺炎 |
| 英文关键词: |
| 基金项目:山西医科大学 第三临床医学院 医疗培育项目（2023xg05-2） |
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| 摘要点击次数: 78 |
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| 中文摘要: |
| 摘要 目的:评估后疫情时代血液病患者合并新型冠状病毒肺炎（CDVID-19）后，芦可替尼对患者疾病转归、生存和不良反应的影响。方法: 回顾性分析38例血液病患者合并CDVID-19且接受芦可替尼治疗的病例资料。主要观察指标包括血常规、C反应蛋白、细胞因子、生化指标、凝血指标、胸部CT、28d内病死率及不良事件。 结果:17例(44.7%)患者在诊断CDVID-19前已经接受芦可替尼治疗，21例(55.3%)感染CDVID-19后联合芦可替尼治疗。CDVID-19前使用芦可替尼患者转为重症的比例为17.6%(3/17)。治疗前观察指标异常的患者中，治疗后62.5%(10/16)的患者白介素-6水平下降，82.1%(23/28)的患者C反应蛋白下降至正常，63.6%(14/22)的患者淋巴细胞减少改善。71.0%(22/31)的患者在CDVID-19诊断后28d内出现胸部CT表现改善。28d内总病死率为2.6%(1/38)。合并重症COVID-19与非重症COVID-19患者相比，病死率无统计学差异(4.8% vs. 0，P＞0.05)。异基因造血干细胞亚组合并CDVID-19患者的病死率为5.6%。在芦可替尼使用过程中未观察到新的安全事件。结论: 芦可替尼对血液病合并CDVID-19患者的炎症指标及预后有一定的改善作用，具有良好的耐受性和安全性。 |
| 英文摘要: |
| Abstract Objective: To assess the effect of ruxolitinib on disease progression, survival, and adverse effects in patients with hematologic diseases who are also infected with the new coronavirus in the post-pandemic era. Methods: A retrospective analysis was performed on the medical records of 38 patients with hematologic diseases who were co-infected with COVID-19 and treated with ruxolitinib. The primary observation indicators included complete blood count, C-reactive protein (CRP), cytokines, biochemical parameters, coagulation tests, chest computed tomography (CT), 28-day mortality, and adverse events. Results: Seventeen patients (44.7%) had been treated with ruxolitinib before the diagnosis of COVID-19, whereas 21 (55.3%) were given ruxolitinib alongside the onset of COVID-19. The rate of progression to severe disease among ruxolitinib-treated patients prior to COVID-19 diagnosis was 17.6% (3/17). Among patients with aberrant baseline laboratory values, 62.5% (10/16) had a substantial drop in IL-6 levels after treatment, and 82.1% (23/28) had normalized their CRP levels. Lymphopenia was improved in 63.6% (14/22)of the patients. Within 28 days of being diagnosed with COVID-19, 71.0% (22/31) of the patients showed a substantial improvement in chest CT. The total mortality rate within 28 days was 2.6% (1/38). There was no statistically significant difference in mortality rate between individuals with and without severe COVID-19 (4.8% vs. 0, P> 0.05). The death rate for allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients who developed COVID-19 was 5.6%. There was no new safety events observed while administering ruxolitinib. Conclusion: Ruxolitinib appears to have a favorable effect on inflammatory markers and prognosis in patients with hematologic diseases co-infected with COVID-19, and it is well tolerated and safe. |
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