摘要
目的比较标准剂量与大剂量阿糖胞苷在急性白血病巩固治疗中的应用效果。方法回顾性选取2019年1月—2022年12月苏州大学附属张家港医院收治的急性白血病巩固治疗患者100例,根据阿糖胞苷药物应用剂量不同分为标准剂量组和大剂量组,每组50例。2组患者在巩固治疗阶段应用相应剂量的注射用阿糖胞苷,2组在每个疗程间均间隔21 d,连续用药4个疗程。比较2组患者临床指标,治疗前后生活质量(健康状况调查简表36)评分,不良反应及近3年无病生存率。结果大剂量组患者血小板减少时间、白细胞减少时间短于标准剂量组,中位存活时间长于标准剂量组(P均<0.01);治疗4个疗程后,2组患者精神状态、生理职能、躯体疼痛及总体健康评分较治疗前升高,且大剂量组高于标准剂量组(P均<0.01);大剂量组与标准剂量组口腔溃疡、肝功能损伤、恶心呕吐、骨髓抑制及皮疹发生率比较差异均无统计学意义(P>0.05);大剂量组与标准剂量组治疗1年后无病生存率比较差异无统计学意义(P>0.05),治疗2、3年后,大剂量组无病生存率(68.00%和52.00%)均高于标准剂量组(40.00%和28.00%,χ^(2)/P=5.769/0.016,6.000/0.014)。结论阿糖胞苷是急性白血病巩固治疗中的常用药物,采用大剂量给药的方式可显著提升临床疗效,提高患者生活质量和近期无病生存率。
Objective To compare the application effect of standard dose and large dose cytarabine in the consolidation therapy of acute leukemia.Methods Retrospectively selected 100 patients with acute leukemia treated in Zhangjiagang Hospital Affiliated to Soochow University from January 2019 to December 2022,and divided them into standard dose group and large dose group according to different dosage of cytarabine,with 50 cases in each group.The two groups were treated with corresponding doses of cytarabine for injection in the consolidation treatment phase.The two groups were treated with drugs for 4 consecutive courses at an interval of 21 days between each course of treatment.The clinical indicators,SF-36 scores before and after treatment,adverse reactions,and disease-free survival rate in the past 3 years were compared between the two groups.Results The time of thrombocytopenia and leukopenia in the large dose group were shorter than those in the standard dose group,and the median time to live was longer than that in the standard dose group(P<0.01);After 4 courses of treatment,the mental state,physiological function,physical pain,and overall health score of the two groups of patients increased compared to before treatment,and the degrees of large dose group were higher than those in the standard dose group(P<0.01);There were no significant difference between the large dose group and the standard dose group in the incidence of Aphthous stomatitis,liver function injury,nausea and vomiting,bone marrow suppression and skin rash(P>0.05);There was no statistically significant difference in disease-free survival rate between the large dose group and the standard dose group after 1 year of treatment(P>0.05).After 2 and 3 years of treatment,the disease-free survival rate of the large dose group(68.00%and 52.00%)were higher than those of the standard dose group(40.00%and 28.00%,χ^(2)/P=5.769/0.016,6.000/0.014).Conclusion Cytarabine is a commonly used drug in the consolidation treatment of acute leukemia.Large dose administration can significantly improve the clinical efficacy and quality of life and short-term disease-free survival rate of patients,which is suitable for popularization and application.
作者
刘丽丽
陈锦豪
LIU Lili;CHEN Jinhao(Department of Pharmacy,Zhangjiagang Hospital Affiliated to Soochow University,Jiangsu Province,Zhangjiagang 215600,China;不详)
出处
《临床合理用药杂志》
2023年第29期22-24,28,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
急性白血病
巩固治疗
阿糖胞苷
治疗效果
Acute leukemia
Consolidation therapy
Cytarabine
Treatment effect
