替莫唑胺联合来那度胺治疗复发性脑胶质瘤的临床疗效及对血清GFAP、VTN及YKL-40的影响  

Clinical Efficacy of Temozolomide Combined with Lenalidomide in the Treatment of Recurrent Glioma and Its Effect on Serum GFAP,VTN and YKL-40

作　　者：何建昌 兰伟途 吴琼 HE Jianchang;LAN Weitu;WU Qiong(Dept.of Neurosurgery,Cangzhou People’s Hospital,Hebei Cangzhou 061000,China)

机构地区：[1]沧州市人民医院神经外科,河北沧州061000

出　　处：《中国医院用药评价与分析》2023年第4期434-437,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究课题计划项目(No.20200172)。

摘　　要：目的:探讨替莫唑胺联合来那度胺治疗复发性脑胶质瘤的临床疗效及对血清胶质纤维酸性蛋白(GFAP)、玻连蛋白(VTN)及甲壳质酶蛋白40(YKL-40)的影响。方法:选取2019年2月至2021年2月该院收治的复发性脑胶质瘤患者80例,通过随机数字表法分为对照组和治疗组,各40例。对照组患者口服替莫唑胺胶囊,治疗组患者在对照组基础上加用来那度胺胶囊。观察两组患者的临床疗效、不良反应及1年生存情况,比较治疗前后血清CD3^(+)、CD4^(+)、CD8^(+)、GFAP、VTN和YKL-40水平。结果:治疗后,治疗组患者的客观缓解率、疾病控制率分别为62.50%(25/40)、82.50%(33/40),明显高于对照组的35.00%(14/40)、57.50%(23/40),差异均有统计学意义(P<0.05)。治疗后,两组患者血清CD3^(+)、CD4^(+)、GFAP、VTN和YKL-40水平明显低于治疗前,血清CD8^(+)水平明显高于治疗前;且治疗组患者治疗后的血清CD3^(+)、CD4^(+)、GFAP、VTN和YKL-40水平明显低于对照组,血清CD8^(+)水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组患者1年生存率为72.50%(29/40),明显高于对照组的40.00%(16/40),差异有统计学意义(P<0.05)。对照组、治疗组患者的不良反应发生率分别为35.00%(14/40)、27.50%(11/40),差异无统计学意义(P>0.05)。结论:替莫唑胺联合来那度胺治疗复发性脑胶质瘤的疗效较好,可改善患者的免疫功能和预后,且安全性好。OBJECTIVE:To probe into the clinical efficacy of temozolomide combined with lenalidomide in the treatment of recurrent glioma and its effects on serum glial fibrillary acidic protein(GFAP),vitronectin(VTN)and chitinase protein 40(YKL-40).METHODS:A total of 80 patients with recurrent glioma admitted to Cangzhou People’s Hospital from Feb.2019 to Feb.2021 were selected and randomly divided into control group and treatment group via random number table method,with 40 cases in each group.The control group were given temozolomide capsules orally,while the treatment group were given lenalidomide based on the control group.The clinical efficacy,adverse drug reactions and 1-year survival rate of the two groups were observed.The levels of serum CD3^(+),CD4^(+),CD8^(+),GFAP,VTN and YKL-40 were compared before and after treatment.RESULTS:After treatment,the objective response rate(ORR)and disease control rate(DCR)were 62.50%(25/40)and 82.50%(33/40)in the treatment group,respectively,which were significantly higher than 35.00%(14/40)and 57.50%(23/40)in the control group,with statistically significant differences(P<0.05).After treatment,the serum CD3^(+),CD4^(+),GFAP,VTN and YKL-40 levels of both groups were significantly lower than those before treatment,while the serum CD8^(+)level was significantly higher than that before treatment;after treatment,the serum CD3^(+),CD4^(+),GFAP,VTN and YKL-40 levels of the treatment group were significantly lower than those of the control group,while the serum CD8^(+)level was significantly higher than that in the control group,with statistically significant differences(P<0.05).After treatment,the 1-year survival rate of the treatment group was 72.50%(29/40),which was significantly higher than that of the control group(40.00%,16/40),with statistically significant difference(P<0.05).The incidences of adverse drug reactions of the control group and treatment group were 35.00%(14/40)and 27.50%(11/40),respectively,the difference was not statistically significant(P>0.05).CONCLUSIONS:The effic

关 键 词：脑胶质瘤 替莫唑胺 来那度胺 胶质纤维酸性蛋白 玻连蛋白 甲壳质酶蛋白40 

分 类 号：R979.1[医药卫生—药品]