放血疗法联合羟基脲或干扰素治疗真性红细胞增多症的疗效及对血清EPO和血象指标的影响  

Curative effect of blood-letting therapy combined with hydroxyurea or interferon in treatment of polycythemia vera and the influence on serum EPO and hemogram indexes

作　　者：谭怡[1,2] 饶治嫦 阳梅[2] 赖玲[2] 王娟[2] TAN Yi;RAO Zhichang;YANG Mei;LAI Ling;WANG Juan(Department of Ultrasound,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Hematology,West China Hospital, Sichuan University, Chengdu 610041,China)

机构地区：[1]四川大学华西医院超声科,四川成都610041 [2]四川大学华西医院血液科,四川成都610041

出　　处：《西部医学》2021年第10期1468-1472,1477,共6页Medical Journal of West China

基　　金：四川省科技厅应用基础项目(2019YJ0454)。

摘　　要：目的探讨放血疗法联合羟基脲或干扰素治疗真性红细胞增多症的疗效及对血清促红细胞生成素(EPO)和血象指标的影响。方法回顾性分析2016年1月~2019年12月我院收治的80例真性红细胞增多症患者的临床资料,根据治疗方案不同分为3组,即23例接受放血疗法患者设为A组,30例接受放血疗法+羟基脲患者设为B组,27例接受放血疗法+干扰素患者设为C组。比较各组临床疗效、血清EPO、血象指标,并分析血清EPO与血象指标的相关性。结果治疗后,A组、B组、C组完全缓解率分别为52.17%、80.00%、81.48%,治疗总有效率分别为69.57%、93.33%、92.59%。A组、B组、C组的血清EPO水平均明显上升(P<0.05),且A组低于B组与C组(P<0.05)。A组、B组、C组的红细胞计数、红细胞比容、血红蛋白、红细胞容量均明显下降(P<0.05),且A组均高于B组与C组(P<0.05)。血清EPO水平与红细胞计数呈负相关(r=0.379,P<0.05)。血清EPO水平与红细胞比容、血红蛋白、红细胞容量、白细胞计数、血小板计数无明显相关性(P>0.05)。结论放血疗法是治疗真性红细胞增多症的基础方法,联合羟基脲或干扰素治疗能够提高临床疗效。血清EPO水平与红细胞计数密切相关,监测血清EPO水平可评估治疗效果。Objective To explore the curative effect of blood-letting therapy combined with hydroxyurea or interferon in treatment of polycythemia vera and the influence on serum erythropoietin(EPO)and hemogram indexes.Methods A retrospective study was conducted among 80 patients with polycythemia vera treated between January 2016 and December 2019.23 patients treated with blood-letting therapy were included in group A,30 patients treated with blood-letting therapy combined with hydroxyurea were included in group B,and 27 patients treated with bloodletting therapy combined with interferon were included in group C.The clinical effect,serum EPO levels and hemological indexes were evaluated.The correlation of serum EPO level with hemological indexes was analyzed.Results After treatment,the complete remission rates of group A,group B and group C were 52.17%,80.00%and 81.48%,respectively.The total effective rates were 69.57%,93.33%and 92.59%,respectively.The level of serum EPO in group A,group B and group C increased significantly(P<0.05),and that in group A was lower than that in group B and group C(P<0.05).The erythrocyte count,hematocrit,hemoglobin and erythrocyte volume in group A,group B and group C decreased significantly(P<0.05),and group A was higher than those in group B and group C(P<0.05).There was a negative correlation between serum EPO level and erythrocyte count(0.379,P<0.05).There was no significant correlation between serum EPO level and hematocrit,hemoglobin,erythrocyte volume,leukocyte count and platelet count(P>0.05).Conclusion Blood-letting therapy is a basic method for treating polycythemia vera.The combined application of hydroxyurea or interferon can improve the clinical effect.Serum EPO levels are closely related to red blood cell counts,and monitoring serum EPO levels can assess the treatment effects.

关 键 词：真性红细胞增多症 放血疗法 促红细胞生成素 羟基脲 干扰素 血象 

分 类 号：R555.1[医药卫生—血液循环系统疾病]