二代酪氨酸激酶抑制剂治疗老年慢性粒细胞性白血病的临床效果  

Clinical effect of second-generation tyrosine kinase inhibitor in the treatment of chronic myeloid leukemia in the elderly

作　　者：毕铭洋 BI Ming-yang(Department of Hematology,Liaoyang Third People’s Hospital,Liaoyang 111000,China)

机构地区：[1]辽阳市第三人民医院血液内科,111000

出　　处：《中国实用医药》2022年第9期14-16,共3页China Practical Medicine

摘　　要：目的分析二代酪氨酸激酶抑制剂(TKI-Ⅱ)治疗老年慢性粒细胞性白血病(CML)的临床效果,为临床医师选择合理用药方案提供参考。方法50例老年CML患者为研究对象,依据随机数字表法分为观察组和对照组,每组25例。对照组患者接受一代酪氨酸激酶抑制剂(TKI-Ⅰ)——伊马替尼治疗,观察组采用TKI-Ⅱ——尼洛替尼治疗。对比两组患者的免疫功能指标、临床疗效指标及不良反应发生率。结果治疗后,观察组患者的CD3^(+)、CD4^(+)/CD8^(+)、NK细胞水平分别为(68.10±2.66)%、(1.55±0.13)、(40.11±4.60)%,均高于对照组的(58.97±2.64)%、(1.23±0.15)、(35.45±4.66)%,差异具有统计学意义(P<0.05)。观察组患者的完全血液学缓解(CHR)、主要细胞遗传学缓解(MCyR)、完全细胞遗传学缓解(CCyR)、主要分子生物学缓解(MMR)率分别为92.0%、92.0%、88.0%、44.0%,均高于对照组的68.0%、48.0%、52.0%、16.0%,差异具有统计学意义(P<0.05)。两组患者的Ⅰ~Ⅱ级、Ⅲ~Ⅳ级不良反应发生率比较,差异无统计学意义(P>0.05)。结论TKI-Ⅱ治疗老年CML的临床效果显著,不仅能增强机体的免疫功能,还能改善临床指标,且不会增加不良反应,安全性较高,值得推广。Objective To analyze the clinical effect of second-generation tyrosine kinase inhibitor(TKI-Ⅱ)in the treatment of chronic myeloid leukemia(CML)in the elderly,so as to provide reference for clinicians to choose rational drug regimens.Methods A total of 50 elderly patients with CML were selected as the research subjects,and were divided into observation group and control group according to the random numerical table,with 25 cases in each group.Patients in the control group received the first-generation tyrosine kinase inhibitor(TKI-Ⅰ)—imatinib,and the observation group received the treatment with TKI-Ⅱ—nilotinib.The immune function indexes,clinical efficacy indexes,and the incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of CD3^(+),CD4^(+)/CD8^(+),and NK cells in the observation group were(68.10±2.66)%,(1.55±0.13),and(40.11±4.60)%,which were higher than(58.97±2.64)%,(1.23±0.15),and(35.45±4.66)%in the control group,and the difference was statistically significant(P<0.05).The rates of complete hematological remission(CHR),major cytogenetic remission(MCyR),complete cytogenetic remission(CCyR),and major molecular remission(MMR)in the observation group were 92.0%,92.0%,88.0%,and 44.0%,which were higher than 68.0%,48.0%,52.0%,and 16.0%in the control group,and the differences were statistically significant(P<0.05).The differences were not statistically significant when comparing the incidence of gradeⅠ-Ⅱand gradeⅢ-Ⅳadverse reactions in the two groups(P>0.05).Conclusion TKI-Ⅱhas significant clinical effect in the treatment of elderly CML,which can not only enhance the immune function of the body,but also improve clinical indicators without increasing adverse reactions.It has high safety and is worthy of promotion.

关 键 词：慢性粒细胞性白血病 二代酪氨酸激酶抑制剂 尼洛替尼 伊马替尼 

分 类 号：R733.72[医药卫生—肿瘤]