达那唑联合沙利度胺治疗骨髓增生异常综合征的临床研究  

Clinical Study of Danazol Combined with Thalidomide in Treatment of Myelodysplastic Syndrome

作　　者：张永晓[1] 付建平[2] 刘晓[1] 李英华[1] 刘珊[1] 王冬梅[1] 陈园园[1] ZHANG Yongxiao;FU Jianping;LIU Xiao;LI Yinghua;LIU Shan;WANG Dongmei;CHEN Yuanyuan(Dept.of Hematology,Harrison International Peace Hospital,Hebei Hengshui 053000,China;Dept.of Cardiology,Harrison International Peace Hospital,Hebei Hengshui 053000,China)

机构地区：[1]衡水市哈励逊国际和平医院血液内科,河北衡水053000 [2]衡水市哈励逊国际和平医院心内科,河北衡水053000

出　　处：《中国医院用药评价与分析》2019年第12期1478-1481,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究重点课题计划（No.20181567）

摘　　要：目的:探讨达那唑联合沙利度胺治疗骨髓增生异常综合征(myelo dysplastic syndromes,MDS)的临床疗效.方法:选取2016年3月至2018年12月衡水市哈励逊国际和平医院收治的MDS患者122例,采用随机信封法分为对照组和观察组,每组61例.对照组患者口服沙利度胺,观察组患者在对照组的基础上加用达那唑.比较两组患者治疗前后炎性因子、血象、骨髓象、临床疗效、血清环氧酶2(COX-2)及组织蛋白酶D(Cath-D)水平、不良反应发生情况和远期生存指标的差异.结果:治疗后,两组患者血清γ干扰素和白细胞介素10水平较治疗前明显降低,且观察组患者明显低于对照组;两组患者血象指标水平较治疗前明显升高,且观察组患者明显高于对照组;两组患者骨髓原始细胞比例较治疗前明显降低,且观察组患者明显低于对照组,上述差异均有统计学意义(P<0.05).观察组患者的总有效率为88.52%(54/61),明显高于对照组的59.02%(36/61),差异有统计学意义(P<0.05).治疗后,两组患者血清COX-2、Cath-D水平较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05).治疗期间,两组患者均出现胃肠道反应、嗜睡、皮疹及肝功能异常等不良反应,症状在治疗期间自行消失.观察组患者的中位无进展生存期为26个月,明显长于对照组的11个月,差异有统计学意义(P<0.001).结论:达那唑联合沙利度胺治疗MDS可有效改善患者的炎性因子水平,优化骨象和骨髓象表征,提高临床疗效,降低血清COX-2、Cath-D水平,延长生存期,安全性好.OBJECTIVE:To probe into the clinical efficacy of danazol combined with thalidomide in treatment of myelodysplastic syndrome(MDS).METHODS:122 patients with MDS admitted into Harrison International Peace Hospital from Mar.2016 to Dec.2018 were selected and divided into control group and observation group via random envelope method,with 61 cases in each group.The control group was treated with thalidomide orally,and the observation group was given danazol combined with thalidomide.Differences in inflammatory factors,hemogram,myelogram,clinical efficacy,serum cyclooxygenase-2(COX-2)and cathepsin-D(Cath-D)levels,incidences of adverse drug reactions and indices of long-term survival were compared between two groups.RESULTS:After treatment,the serum IFN-γand IL-10 levels of both groups had been significantly decreased,and that of the observation group was significantly lower than the control group;the hemogram indices of both groups had been significantly increased,and that of the observation group was significantly higher than the control group;the proportion of bone marrow blast cell of both groups had been significantly decreased,and that of the observation group was significantly lower than the control group,with statistically significant differences(P<0.05).The total effective rate of observation group was 88.52%(54/61),which was significantly higher than that of the control group(59.02%,36/61),with statistically significant difference(P<0.05).After treatment,the serum COX-2 and Cath-D levels of both groups had been significantly decreased,and that of the observation group was significantly lower than the control group,with statistically significant difference(P<0.05).During treatment,adverse drug reactions such as gastrointestinal reactions,lethargy,rash and abnormal liver function occurred in both groups,while all the symptoms disappeared during the treatment.The median progression-free survival of observation group was 26 months,which was significantly longer than that of the control group(11 months),with stati

关 键 词：达那唑 沙利度胺 骨髓增生异常综合征 临床研究 

分 类 号：R977.1[医药卫生—药品] R979.5[医药卫生—药学]