阿糖胞苷联合粒细胞集落刺激因子治疗低增生性白血病疗效观察  

Curative effect of cytarabine combined with granulocyte colony-stimulating factor in the treatment of hypo-cellular leukemia

作　　者：秦卫玲[1] 董学艳[2] 窦敬芳[1] 贺立山[3] QIN Wei-ling DONG Xue-yan DOU Jing-fang HE Li-shan(Department of Hematopathy, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, Henan Province, China Department of Neurosurgery , the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang 453003, Henan Province, China Department of Hematopathy, the First Affiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China)

机构地区：[1]新乡医学院第三附属医院血液内科,河南新乡453003 [2]新乡医学院第三附属医院神经外科,河南新乡453003 [3]新乡医学院第一附属医院血液内科,河南卫辉453100

出　　处：《新乡医学院学报》2016年第1期41-44,共4页Journal of Xinxiang Medical University

摘　　要：目的评价阿糖胞苷(Ara-C)联合粒细胞集落刺激因子(G-CSF)治疗低增生性白血病(HLA)的临床效果。方法 56例HLA患者随机分为对照组和观察组,每组28例,对照组患者应用柔红霉素(DNR)联合Ara-C组成的DA方案治疗,观察组患者应用小剂量Ara-C联合G-CSF组成的改良AG预激方案治疗,治疗2个疗程后分别评价完全缓解率、总有效率、不良反应及平均住院费用。结果所有患者均完成相应方案的治疗,无治疗相关死亡事件及中途停止、退出者。观察组患者第1个疗程完全缓解率及治疗结束后总有效率分别为32.1%和78.6%,显著高于对照组的21.4%和41.4%(P<0.05)。对照组患者中性粒细胞缺乏发生率为85.7%,白细胞减少持续中位时间为12 d;血小板缺乏发生率为64.2%,持续中位时间为11 d,化学治疗期间患者感染发生率为82.1%;观察组患者中性粒细胞缺乏发生率为46.4%,白细胞减少持续中位时间为9 d;血小板缺乏发生率为39.2%,持续中位时间为7 d,化学治疗期间患者感染发生率为57.1%;观察组患者中性粒细胞缺乏发生率、白细胞减少持续时间中位数、血小板缺乏发生率、血小板缺乏持续中位时间和感染发生率均显著低于对照组(P<0.05)。观察组患者的消化道反应发生率、平均治疗费用均显著低于对照组(P<0.05)。结论改良AG预激方案可以有效缓解HAL,且不良反应少,总有效率高,但该方案的远期治疗效果仍有待进一步研究。Objective To evaluate the clinical effect of cytarabine combined with granuloeyte colony-stimulating factor （G-CSF） in the treatment of hypo-eellular leukemia. Methods Fifty-six patients who were diagnosed as hypo-cellular leukemia were randomly divided into control group and observation group, twenty-eight cases in each group. The patients in the control group received DA therapeutic regime which was composed with daunorubiein and eytarabine, while the patients in the observation group received AG improved regime which was made by low dose of eytarabine combined and G-CSF at the same time. The complete remission rate, total effective rate, adverse reaction and the average cost in the hospital were evaluated after two course of treatment respectively. Results All patients survived after two course of treatment and there was no death event related to treatment or midway stop or quit. The complete remission rate after one course of treatment and total effective rate after two course of treatment of the observation group were 32.1% and 78.6% respectively,which were significantly higher than those of the control group（21.4% and 41.4% ） （P 〈 0.05 ）. The incidence of neutropenia of the control group was 85.7% , and the median duration time of aleueoeytosis was 12 days. The rate of aleukia was 64.2% and the median duration time of aleukia was 11 days. During of the period of chemical treatment, the rate of infection of the control group was 82.1%. These above-mentioned parameters of the observation group,however,were 46.4% ,9 days,39.2% ,7 days and 57.1% respectively. The incidence of neutropenia,the median duration time of aleueoeytosis,the rate of aleukia,the median duration time of aleukia, the rate of infection, incidence of gastrointestinal reaction and the average cost in the hospital in the observation group were significantly lower than those in the control group （P 〈 0. 05 ）. Conclusion AG improved regime can remit hypo-cellular leukemia effectively, and has the advantage of few adverse eff

关 键 词：低增生性白血病 阿糖胞苷 粒细胞集落刺激因子 不良反应 

分 类 号：R557[医药卫生—血液循环系统疾病]