不同剂量阿糖胞苷联合伊达比星治疗急性髓细胞性白血病患者的疗效及安全性观察  

Effects and Safety of Different Doses of Cytarabine Combined with Idarubicin in Patients with Acute Myeloid Leukemia

作　　者：李小雨 秦福丽 孙晓燕 郭志强 LI Xiao-yu;QIN Fu-li;SUN Xiao-yan;GUO Zhi-qiang(Department of Hematology,Zhengzhou Central Hospital,Zhengzhou 450007,China)

机构地区：[1]郑州大学附属郑州中心医院,郑州450007

出　　处：《中国合理用药探索》2022年第4期71-76,共6页Chinese Journal of Rational Drug Use

基　　金：河南省高等学校重点科研项目计划(21A310025)。

摘　　要：目的:探讨不同剂量阿糖胞苷联合伊达比星对急性髓细胞性白血病患者免疫因子、血小板的影响及其不良反应。方法:回顾性选取2017年3月~2019年7月期间本院收治的急性髓细胞性白血病患者90例,根据其治疗方案分为对照组和观察组。两组均经诱导化疗缓解后,在巩固治疗阶段给予注射用盐酸伊达比星,每次10mg/m^(2),qd,第1~3天连续给药,28天为1个疗程,共进行4个疗程的强化治疗。对照组和观察组在此基础上分别加用1g/m^(2)和3g/m^(2)注射用盐酸阿糖胞苷,间隔1天给药,第1、3、5天均静脉滴注2次,28天为1个疗程,共进行4个疗程的强化治疗。治疗后两组患者均门诊或电话随访至2020年11月10日。统计比较患者治疗前、治疗2个疗程和治疗4个疗程后的T淋巴细胞亚群、血清白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)、IL-12等免疫相关因子和血小板计数水平;统计比较两组1年生存率、复发率等预后指标;统计比较两组不良反应发生率。结果:观察组1年生存率高于对照组,且复发率低于对照组(P<0.05)。与同组治疗前比较,两组治疗2个疗程和治疗4个疗程后的CD3^(+)、CD4^(+)、血清IL-10水平均降低,CD8^(+)、血清IFN-γ、IL-12水平均升高(P<0.05);观察组治疗2个疗程和治疗4个疗程后的CD3^(+)、CD4^(+)、血清IFN-γ、IL-12水平均高于对照组,CD8^(+)、血清IL-10水平则低于对照组(P<0.05)。与同组治疗前比较,两组治疗2个疗程和治疗4个疗程的血小板计数水平均降低(P<0.05);但两组间血小板计数水平比较无统计学差异(P>0.05)。两组间不良反应发生率比较无统计学差异(P>0.05)。结论:3g/m^(2)阿糖胞苷与伊达比星联用对急性髓细胞性白血病患者免疫功能和预后的改善作用更佳,且安全可靠。Objective:To investigate the effects of different doses of cytarabine on immune factors and platelets and adverse reactions in patients with acute myeloid leukemia.Methods:A total of 90 patients with acute myeloid leukemia from March 2017 to July 2019 were retrospectively selected and divided into the control group and the observation group according to the treatment plan.Both groups were relieved by induction chemotherapy,and were given idarubicin hydrochloride for injection in the consolidation treatment stage,10 mg/m^(2)every time,qd,continuous administration for 1 to 3 days,28 days as a course of treatment.A total of 4 courses of intensive therapy were required.The control group and the observation group were additionally given 1 g/m^(2)and 3 g/m^(2)cytarabine hydrochloride for injection on this basis,day 1,day 3 and day 5 were intravenous drip twice,28 days as a course of treatment,a total of 4 courses of intensive treatment were required.After treatment,both groups were followed up by outpatient or telephone until November 10,2020.T lymphocyte subsets,serum Interleukin(IL-10),interferon-γ(IFN-γ),IL-12 and other immune related factors,platelet count levels before treatment,2 courses of treatment and 4 courses of treatment in the 2groups were compared.The 1-year survival rate,recurrence rate and other prognostic indicators between the two groups were statistically compared.The incidence rate of adverse reactions was statistically compared between the two groups.Results:The 1-yearsurvival rate of the observation group was higher than that of the control group,and the recurrence rate of the observation group was lower than that of the control group(P<0.05).Compared in the same group before treatment,the levels of CD3^(+),CD4^(+)and serum IL-10 in the two groups after 2 courses and 4 courses of treatment were decreased,while the levels of CD8^(+),serum IFN-γand IL-12 were increased(P<0.05);and the levels of CD3^(+),CD4^(+)and serum IL-10 in the control group were higher than those in the observation group whi

关 键 词：不同剂量 阿糖胞苷 伊达比星 强化治疗 急性髓细胞性白血病 免疫相关因子 血小板 毒副作用 

分 类 号：R733[医药卫生—肿瘤]