【摘要】 背景弥漫大B细胞淋巴瘤的主要治疗方式是免疫化疗。而大多数化疗药物在体内的转运依赖于肾脏的参与。对于弥漫大B细胞淋巴瘤患者而言，合并重度肾功能不全无疑给治疗带来了极大的挑战。治疗过程中，需要医生和药师密切配合，在保障患者安全的前提下，最大程度提升患者的治疗获益。目的 本文探讨了医药联合在弥漫大B细胞淋巴瘤(DLBCL)合并急性肾功能衰竭患者治疗中的服务模式，旨在建立有效的防治措施。方法 以1例晚期弥漫大B细胞淋巴瘤合并急性肾功能衰竭患者使用维泊妥珠单抗联合免疫化疗临床资料为例，探讨病因、预后评估、治疗可行性、肿瘤溶解综合征风险评估管理、治疗方案的调整、药学监护要点分析、透析时机的把握等。结果 患者治疗过程平稳，未发生肿瘤溶解综合征，经过2周期治疗后，肿瘤压迫症状减轻，肾功能损伤得到有效缓解，乳酸脱氢酶水平趋于正常。结论 弥漫大B细胞淋巴瘤合并肾功能不全患者的个体差异较大，临床治疗方案应在明确检查、全面评估的基础上进行个体化治疗。医生与药师应加强沟通，保障治疗安全有效。更多还原

【Abstract】 Background The main treatment for diffuse large B-cell lymphoma is immunochemotherapy. However,the transport of most chemotherapy drugs in the body relies on the participation of the kidneys. For patients with diffuse large B-cell lymphoma, the coexistence of severe renal insufficiency undoubtedly poses a significant challenge to treatment. During the treatment process, doctors and pharmacists need to closely cooperate to maximize the therapeutic benefits for patients while ensuring their safety. Objective To explore the treatment service model for patients with diffuse large B-cell lymphoma complicated by acute renal failure, so as to establish effective preventive and treatment measures. Methods Taking the clinical data of a patient with diffuse large B-cell lymphoma complicated with severe renal insufficiency who received polatuzumab vedotin combined with chemotherapy as an example. Explore the etiology, prognostic assessment, treatment feasibility, risk assessment and management of tumor lysis syndrome, adjustment of treatment regimens, key points of pharmaceutical care analysis and determination of dialysis timing, etc. Results The patient’s treatment process was stable, and no tumor lysis syndrome occurred.After 2 cycles of treatment, the symptoms of tumor compression were relieved, acute renal failure was effectively alleviated, and the lactate dehydrogenase level tended to be normal. Conclusion There are significant individual differences among patients with diffuse large B-cell lymphoma complicated by renal failure. The clinical treatment regimens should be individualized based on clear examinations and comprehensive assessments. Doctors and pharmacists should strengthen communication to ensure the safety and effectiveness of treatment.更多还原