文章摘要
阿扎胞苷联合小剂量阿糖胞苷治疗中高危骨髓增生异常综合征患者的疗效及安全性
Efficacy and safety of azacitidine combined with low-dose cytarabine in treatment of patients with moderate and high-risk myelodysplastic syndromes
投稿时间:2021-09-27  
DOI:10.3969/j.issn.1000-0399.2022.10.002
中文关键词: 中高危骨髓增生异常综合征  阿扎胞苷  小剂量阿糖胞苷  免疫功能  安全性
英文关键词: Medium to high risk myelodysplastic syndrome  Azacitidine  Low-dose cytarabine  Immune function  Safety
基金项目:邢台市科技计划项目 (项目编号:2019ZC296)
作者单位
王佩 054001 河北邢台 邢台市第一医院血液科 
董照 054001 河北邢台 邢台市第一医院血液科 
杨艳敏 054001 河北邢台 邢台市第一医院血液科 
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中文摘要:
      目的 研究阿扎胞苷联合小剂量阿糖胞苷治疗中高危骨髓增生异常综合征(MDS)患者的疗效及安全性。方法 选取2018年1月至2020年6月邢台市第一医院血液科收治的100例中高危MDS患者为研究对象,按随机数字表法分为研究组和对照组,各50例。对照组行小剂量阿糖胞苷治疗,研究组行阿扎胞苷联合小剂量阿糖胞苷治疗,21 d为1个疗程,干预3个疗程后,比较分析两组患者临床疗效,治疗前后患者铁蛋白、维生素B12与叶酸水平,p15、SOCS1基因的甲基化状态以及不良反应(骨髓抑制、感染、恶心呕吐等)发生情况。结果 研究组治疗总有效率(81.25%)高于对照组(62.00%),差异有统计学意义(P<0.05);两组患者治疗前后铁蛋白、维生素B12差值比较,差异有统计学意义(P<0.05);两组患者治疗前后叶酸差值比较,差异无统计学意义(P>0.05);研究组患者治疗后p15(2.00%)、SOCS1(4.00%)基因甲基化率明显低于对照组(14.00%比14.00%),差异均有统计学意义(P<0.05);研究组治疗期间不良反应发生率(16.00%)低于对照组(18.00%),差异无统计学意义(P>0.05)。结论 阿扎胞苷联合小剂量阿糖胞苷治疗有助于提高中高危MDS患者的临床疗效,改善生存状态,安全性较高,值得临床应用。
英文摘要:
      Objective To study the efficacy and safety of azacitidine combined with low-dose cytarabine in the treatment of patients withmoderate to high-risk myelodysplastic syndrome (MDS). Methods A total of 100 middle-high-risk MDS patients admitted between January 2018 and June 2020 were selected as the research objects, and they were divided into the study group and the control group according to the random number table method, with 50 cases in each. The control group received low-dose cytarabine treatment, and the study group received azacitidine combined with low-dose cytarabine treatment;one course of treatmentlasted21 days. After three courses of intervention, the clinical effects of the two groups, the levels of ferritin, vitamin B12 and folic acid, the methylation status of p15 and SOCS1 genes and the occurrence of adverse reactions (bone marrow suppression, infection, nausea and vomiting, etc.) before and after treatment were compared and analyzed. Results The total effective rate of the study group (81.25%) was significantly higher than that of the control group (62.00%) (P<0.05); there was significant difference in ferritin and vitamin B12 between the two groups before and after treatment (P<0.05); there was no significant difference in folic acid between the two groups before and after treatment (P>0.05); The methylation rates of p15 (2.00%) and SOCS1 gene (4.00%) in the study group were significantly lower than those in the control group (14.00%, 14.00%) (P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups (16.00% inthe experimental group, 18.00% inthe control group) (P>0.05). Conclusions Azacitidine combined with low-dose cytarabine therapy can help improve the clinical efficacy of patients with moderate to high risk of MDS, improve survival and have high safety,thus it is worth clinical application.
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