达沙替尼二线治疗慢性粒细胞白血病的效果分析  

Efficacy of second-line therapy with dasatinib in the treatment of chronic myeloid leukemia

作　　者：侯甲福 李洁 刘世娟 耿艳萌[4] 张颖 Hou Jiafu;Li jie;Liu Shijuan;Geng Yanmeng;Zhang Ying(Department of Pharmacy,School of Pharmacy,Mudanjiang Medical University,Mudanjiang 157011,Heilongjiang Province,China;Department of Hematology,Hongqi Hospital of Mudanjiang Medical University,Mudanjiang 157011,Heilongjiang Province,China;Department of Pharmacy,Hongqi Hospital of Mudanjiang Medical University,Mudanjiang 157011,Heilongjiang Province,China;Department of Psychology,School of Public Health,Mudanjiang Medical University,Mudanjiang 157011,Heilongjiang Province,China)

机构地区：[1]牡丹江医学院药学院药剂学教研室,牡丹江157011 [2]牡丹江医学院附属红旗医院血液科,牡丹江157011 [3]牡丹江医学院附属红旗医院药学部,牡丹江157011 [4]牡丹江医学院公共卫生学院心理教研室,牡丹江157011

出　　处：《中国基层医药》2022年第9期1315-1319,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：黑龙江省省属高等学校科研项目(2019-KYYWFMY-0062)。

摘　　要：目的探讨治疗慢性粒细胞性白血病(CML)二线药物达沙替尼(DST)在临床治疗中的效果。方法选取牡丹江医学院附属红旗医院2015年1月至2021年1月收治的因伊马替尼耐药或者不耐受的慢性期慢性粒细胞白血病(CP-CML)患者60例为观察对象,采用随机数字表法分为对照组与观察组,每组30例。对照组采用常规化疗进行治疗,观察组采用常规化疗+达沙替尼口服治疗,治疗期为6个月。比较两组临床疗效、免疫功能指标、生存质量评分及不良反应率(肝功能异常、皮疹、疲乏、外周水肿、恶心呕吐、脱发等)。结果观察组客观缓解率(ORR)[83.33%(25/30)]高于对照组[53.33%(16/30)](χ^(2)=6.23,P<0.05)。治疗前,两组各项免疫功能指标比较,差异均无统计学意义(t=0.03、0.20、0.44,均P>0.05)。治疗后,观察组CD_(4)/CD_(8)(1.03±0.32)、CD_(3)^(+)[(43.77±6.62)%]、NK细胞[(31.12±3.38)%]均显著高于对照组[(0.74±0.28)、(35.79±6.27)%、(28.22±2.84)%](t=3.69、4.78、3.60,均P<0.05);观察组社会功能[(85.48±6.25)分]、物资生活[(80.12±6.34)分]、心理健康[(79.94±6.48)分]、躯体健康[(77.92±5.81)分]均显著高于对照组[(72.79±5.89)分、(63.47±5.82)分、(68.87±6.08)分、(63.14±6.12)分](t=7.91、10.59、6.82、9.59,均P<0.05);观察组总不良反应率[16.67%(5/30)]显著低于对照组[40.00%(12/30)](χ^(2)=4.02,P<0.05)。结论达沙替尼治疗CP-CML疗效确切、安全可靠,可有效提高临床疗效和化疗安全性,同时能改善患者的免疫功能指标与生存质量。Objective To investigate the clinical efficacy of second-line therapy with dasatinib in the treatment of chronic myeloid leukemia.Methods Sixty patients with chronic phase chronic myeloid leukemia who received treatment in Hongqi Hospital of Mudanjiang Medical University between January 2015 and January 2021 were included in this study.They were randomly divided into control and observation groups,with 30 patients in each group.The control group was treated with conventional chemotherapy,and the observation group was treated with conventional chemotherapy combined with oral dasatinib.All patients were treated for 6 months.Clinical efficacy,immune function indexes,quality of life score,and incidence of adverse reactions(abnormal liver function,rash,fatigue,peripheral edema,nausea and vomiting,alopecia)were compared between the two groups.Results Objective response rate(ORR)in the observation group was significantly higher than that in the control group[83.33%(25/30)vs.53.33%(16/30),χ^(2)=6.23,P<0.05].Before treatment,there were no significant difference in immune function indicators between the two groups(t=0.03,0.20,0.44,all P>0.05).After treatment,CD_(4)/CD_(8),CD_(3)^(+)and natural killer cells in the observation group were(1.03±0.32),(43.77±6.62)%,(31.12±3.38)%,respectively,which were significantly higher than(0.74±0.28),(35.79±6.27)%,(28.22±2.84)%in the control group(t=3.69,4.78,3.60,all P<0.05).The scores of social functioning,material well-being life,mental health,somatic health in the observation group were(85.48±6.25)points,(80.12±6.34)points,(79.94±6.48)points,and(77.92±5.81)points,respectively,which were significantly higher than(72.79±5.89)points,(63.47±5.82)points,(68.87±6.08)points,(63.14±6.12)points in the control group(t=7.91,10.59,6.82,9.59,all P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group[16.67%(5/30)vs.40.00%(12/30),χ^(2)=4.02,P<0.05].Conclusion Second-line therapy with dasatinib for chronic phase chroni

关 键 词：白血病 髓样 慢性期 达沙替尼 药物疗法 联合 分子靶向治疗 细胞遗传学分析 药物相关性副作用和不良反应 安全 生活质量 治疗结果 

分 类 号：R733.72[医药卫生—肿瘤]