急性髓系白血病精准诊疗模式的优化与探讨  

The optimization and discussion of the accurate diagnosis and treatment model of acute myeloid leukemia

作　　者：秦晓铧[1] 陈小宇[1] 洪雅萍[1] 

机构地区：[1]广东省惠州市中心人民医院,广东惠州516000

出　　处：《中国医药科学》2018年第1期191-193,210,共4页China Medicine And Pharmacy

摘　　要：目的对急性髓系白血病精准诊疗模式的优化进行探讨。方法随机抽取2016年1月~2017年6月我院急性髓系白血病患者124例,均经初始诊断选择规范化早期治疗方案。化疗后复查骨髓分为两组,根据患者治疗情况分为完全缓解组(48例)和非完全缓解组(76例)。分析治疗后非完全缓解组存在的骨髓免疫表型,分子生物学,细胞遗传学的差异。综合多种参数包括治疗反应等进行治疗后二次诊断并对高危指标进行二次评估,针对实验室检查差异结果分析选择不一样的治疗方案。结果完全缓解组患者临床并发症发生率低于非完全缓解组患者,完全缓解组患者进行治疗的平均费用低于非完全缓解组患者,差异具有统计学意义(P<0.05)。完全缓解组治疗满意度达到95.8%,非完全缓解组79.0%,差异具有统计学意义(P<0.05)。结论对急性髓系白血病患者采用精准诊疗的诊疗模式进行诊疗,能够有效使急性髓系白血病的并发症发生率降低,并帮助患者大幅度节约治疗所需费用,具有临床推广价值。Objective To discuss the optimization of accurate diagnosis and treatment of acute myeloid leukemia. Methods 124 cases of acute myeloid leukemia in our hospital from January 2016 to June 2017 were randomly selected.The initial diagnosis was performed and the standardized early treatment program were selected.After chemotherapy,they were divided into two groups according to reexamination of bone marrow.According to the patient＇s treatment,the patients were divided into complete remission group （48 cases） and non complete remission group （76 cases）.The differences in bone marrow immunophenotype,molecular biology and cytogenetics in the non complete remission group after treatment were analyzed.A comprehensive variety of parameters,including therapeutic response,were diagnosed two times after treatment and two evaluations of high risk indicators were performed. Results The incidence of clinical complications in the complete remission group was lower than that in the non complete remission group,and the average cost of treatment in the complete remission group was lower than that in the non complete remission group （P 〈 0.05）. The satisfaction of the complete remission group was 95.8% and that of the non complete remission group was 79%,and the difference was statistically significant （P〈0.05）. Conclusion The diagnosis and treatment of acute myeloid leukemia patients with precise diagnosis and treatment can effectively reduce the incidence of complications of acute myeloid leukemia,and help patients save substantially the cost of treatment, which is of clinical value.

关 键 词：急性白血病 异质性 精确诊断 优化 

分 类 号：R378.911[医药卫生—病原生物学]