沙利度胺联合常规化疗治疗急性髓细胞白血病的效果  

Effect of Thalidomide combined with conventional chemotherapy treating acute myeloid leukemia

作　　者：张丽仪[1] 

机构地区：[1]广东省东莞市人民医院血液科,广东东莞523000

出　　处：《中国当代医药》2017年第11期31-34,共4页China Modern Medicine

摘　　要：目的探讨沙利度胺联合常规化疗治疗急性髓细胞白血病(AML)的效果。方法选取我院2013年1~12月明确诊断为初发AML的患者63例,根据治疗方法将患者分为沙利度胺联合常规化疗组(联合组)35例和常规化疗组(对照组)28例。两组患者均采用DA化疗方案给予治疗4个疗程(7 d为1个疗程),同时给予联合组口服沙利度胺4个月。记录并比较两组治疗前后的血管内皮生长因子(VEGF)、血管内皮生长因子受体(VEGFR)、碱性成纤维细胞生长因子(b FGF)及骨髓微血管密度(MVD)水平变化和远期生存情况,分析其疗效和不良反应发生情况。结果联合组治疗有效率为88.57%,高于对照组的60.71%,差异有统计学意义(P<0.05)。治疗后,两组的VEGF、VEGFR、b FGF和MVD水平均较治疗前低,差异有统计学意义(P<0.05)。治疗后,联合组VEGF、VEGFR和MVD水平均低于对照组,差异有统计学意义(P<0.05)。联合组消化系统症状的发生率(65.71%)高于对照组(17.86%),差异有统计学意义(P<0.05),两组其他的不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙利度胺联合常规化疗可有效抑制AML患者体内VEGF、VEGFR的表达和生成骨髓微血管,通过抗血管生成显著提高临床疗效,但对患者的远期生存率无显著影响。Objective To investigate the effect of Thalidomide combined with conventional chemotherapy treating acute myeloid leukemia （AML）2dethods Sixty-three newly diagnosed AML in our hospital from January to December 2013.were selected.They were divided into Thalidomide combined with routine chemotherapy group （combined group,35 cases） and rou- tine chemotherapy group （control group,28 cases）.All patients were treated with DA chemotherapy regimen for 4 courses （7 d for a course of treatment）,while the combined group was given thalidomide for 4 months.The changes of VEGF, VEGFR,bFGF,MVD and the long-term survival status in the two groups were recorded and compared,the efficacy and incidence of adverse reactions were analyzed.Results The effective rate in the combined group Was 88.57%,and it was significantly higher than 60.71% in the control group （P〈O.O5）.After treatment,the level of VEGF,VEGFR,bFGF and MVD in the two groups were significantly lower than those before treatment （P〈0.05）.And the level of VEGF,VEGFR and MVD in the combined group were significantly lower than those in the control group （P〈0.05）.There was no significant differ- ence in the incidence of adverse reactions between the two groups （P〉0.05） besides digestive system symptoms,which in the combined group （65.71%） was significantly higher than that in the control group （17.86%）.Conclusion The therapy of Thalidomide combined with conventional chemotherapy can effectively inhibit the expression of VEGF and VEGFR and the production of bone marrow microvessets in patients with AML.But it had no significant effect on the patients＇ long-term survival rate.

关 键 词：沙利度胺 急性髓细胞白血病 血管内皮生长因子 碱性成纤维细胞生长因子 骨髓微血管密度 远期生存率 

分 类 号：R733.71[医药卫生—肿瘤]