摘要
目的探讨地西他滨联合高三尖杉酯碱+阿糖胞苷+重组人粒细胞集落刺激因子(小剂量HAG方案)在老年急性髓系白血病患者中的应用及新思路。方法选取2016年1月至10月间江苏省无锡市人民医院收治的68例老年急性髓系白血病患者,采用随机数表法分为观察组和对照组,每组34例。观察组患者采用地西他滨联合小剂量HAG方案化疗,对照组患者采用阿糖胞苷+阿克拉霉素+重组人粒细胞集落刺激因子(CAG方案)化疗。观察比较两组患者治疗后的疗效、CD4^+、CD8^+和CD4^+/CD8^+水平及不良反应。结果观察组患者总有效率为91.2%,高于对照组患者的67.6%,差异有统计学意义(P<0.05)。治疗前,两组患者CD4^+、CD8^+及CD4^+/CD8^+水平比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的CD4^+和CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组,差异均有统计学意义(均P<0.05)。两组患者的不良反应为胃肠道反应、肝功能异常、呼吸感染和发热等,后经处理,症状缓解。两组患者各项不良发应发生率比较,差异无统计学意义(P>0.05)。结论地西他滨联合小剂量HAG在老年急性髓系白血病患者中的应用效果显著,安全性较高,值得临床推广。
Objective To explore decitabine combined with small dose of homoharringtonine plus cytarabine and recombinant human granulocyte colony-stimulating factor（HAG） in patients with acute myeloid leukemia to provide new ideas and new directions for clinical treatment of acute myeloid leukemia.Methods Sixty-eight patients with acute myeloid leukemia treated at Wuxi Municipal People＇s Hospital were selected from January 2016 to October 2016.Using a random number table,patients were randomly divided into an observation group and a control group with 34 patients in each group.The observation group was treated with decitabine combined with small dose of HAG and the control group received cytarabine plus aclamycin and granulocyte colony-stimulating factor（CAG）.Treatment efficacy,and levels of CD4~＋,CD8~＋ and CD4~＋/CD8~＋ as well as adverse reactions were compared between the two groups.Results The overall efficacy rate was 91.2% which was higher than 67.6% of the control group（P0.05）.There was no significant difference in the levels of CD4~＋,CD8~＋ and CD4~＋/CD8~＋ between the two groups before the treatment（P0.05）.After the treatment,levels of CD4~＋ and CD4~＋/CD8~＋ were significantly higher in the observation group than in the control group and CD8~＋ was significantly lower in the observation group than in the control group（P0.05）.Adverse reactions included gastrointestinal reactions,dysfunction of liver,respiratory infection and fever,which relieved after management of antiemesis,and liver conserving,stomach conserving therapy,albumin infusion and support treatment.There was no significant difference in the incidence of adverse reactions between the two groups（P0.05）.Conclusion The capecitabine combined with low-dose HAG is effective and safe in patients with acute myeloid leukemia and is worthy of clinical promotion.
出处
《中国肿瘤临床与康复》
2017年第9期1074-1077,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
2016年度江苏省医学新技术引进项目(2016-211-1)
