干扰素注射液联合阿司匹林肠溶片和羟基脲片治疗JAK2V617F基因突变阳性真性红细胞增多症患者的临床研究  

Clinical trial of interferon injection combined with aspirin enteric-coated tablets combined with hydroxyurea tablets in the treatment of patients with JAK2V617F mutation-positive polycythemia vera

作　　者：李志赏 闫广辉 刘珊 LI Zhi-shang;YAN Guang-hui;LIU Shan(Department of Blood Center,Hengshui People’s Hospital,Hengshui 053000,Hebei Province,China;Department of Orthopaedics Clinic,Hengshui People’s Hospital,Hengshui 053000,Hebei Province,China)

机构地区：[1]衡水市人民医院血液科,河北衡水053000 [2]衡水市人民医院骨科,河北衡水053000

出　　处：《中国临床药理学杂志》2023年第7期941-945,共5页The Chinese Journal of Clinical Pharmacology

基　　金：河北省医学科学研究课题计划基金资助项目(20191771)。

摘　　要：目的 观察干扰素注射液联合阿司匹林肠溶片和羟基脲片治疗对JAK2V617F基因突变阳性的真性红细胞增多症(PV)患者血液学指标和凝血功能的影响。方法 将JAK2V617F基因突变阳性PV患者随机分为对照组和试验组。对照组给予阿司匹林肠溶片,每次100 mg,每天1次,口服+羟基脲片20 mg·kg^(-1),每天1次,完全缓解后降低剂量至10 mg·kg^(-1),每天1次;试验组在对照组治疗的基础上,给予重组人干扰素α-2a注射液,每次3.0×10^(6)U,隔日1次,肌内注射。2组患者均治疗6个月。比较2组患者的临床疗效、血液学指标、凝血功能及药物不良反应发生情况。结果 对照组和试验组各49例。治疗后,试验组和对照组的总有效率分别为91.84%和75.51%,差异有统计学意义(P<0.05)。治疗后,试验组和对照组的外周血血小板水平分别为(124.83±19.73)×10^(9)和(168.95±23.47)×10^(9)·L^(-1),外周血白细胞水平分别为(4.98±1.22)×10^(9)和(8.46±1.98)×10^(9)·L^(-1),外周血血细胞比容分别为(33.50±4.06)%和(39.20±4.63)%,血清血红蛋白水平分别为(148.77±18.69)和(177.59±19.60)g·L^(-1),血清促红细胞生成素水平分别为(29.84±3.46)和(18.59±2.41)U·L^(-1),血清细胞因子传导抑制蛋白3 mRNA水平分别为0.11±0.02和0.26±0.04,部分凝血活酶时间分别为(33.72±5.59)和(39.58±5.76)s,凝血酶原时间分别为(11.58±2.54)和(14.64±2.10)s,凝血酶时间分别为(13.09±2.55)和(18.38±2.58)s,血清纤维蛋白原水平分别为(3.02±0.89)和(4.11±1.10)g·L^(-1),差异均有统计学意义(均P<0.05)。治疗期间,试验组和对照组的总药物不良反应发生率分别为16.33%和12.24%,差异无统计学意义(P>0.05)。结论 干扰素联合阿司匹林和羟基脲治疗JAK2V617F基因突变阳性PV患者可有效改善患者血液学指标和凝血功能,具有较好的治疗效果,且安全性良好。Objective To observe the effects of interferon injection combined with aspirin enteric-coated tablets and hydroxyurea tablets on hematological indicators and coagulation function of JAK2V617F mutation-positive polycytophilia(PV).Methods The JAK2V617F mutation-positive PV patients were randomly divided into control group and treatment group by random number table method. Control group was treated with aspirin enteric - coated tabletscombined with hydroxyurea tablets + aspirin enteric - coated tablets were orally administered at 100 mg·kg^(-1),once aday,and hydroxyurea tablets 20 mg·kg^(-1),once a day,after complete remission,the dosage was reduced to 10mg·kg^(-1),once a day. On the basis of control group,treatment group was treated with recombinant human interferonα - 2b injection,intramuscular injection,3. 0 × 10^(6) U,once every other day. Both groups were treated for 6 months.The clinical efficacy,hematological indexes,coagulation function and adverse drug reactions were compared betweenthe two groups. Results There were 49 cases in both treatment group and control group. After treatment,the totaleffective rate of treatment group and control group were 91. 84% and 75. 51%,the difference was statisticallysignificant ( P < 0. 05) . After treatment,the levels of platelets of the peripheral blood in the treatment group and thecontrol group were ( 124. 83 ± 19. 73) × 10^(9) and ( 168. 95 ± 23. 47) × 10^(9)·L^(-1);the levels of white blood cells of theperipheral blood were ( 4. 98 ± 1. 22) × 10^(9) and ( 8. 46 ± 1. 98) × 10^(9)·L^(-1);hematocrit of the peripheral blood were( 33. 50 ± 4. 06 ) % and ( 39. 20 ± 4. 63 ) %;the levels of serum hemoglobin were ( 148. 77 ± 18. 69 ) and( 177. 59 ± 19. 60) g·L^(-1);the levels of serum erythropoietin were ( 29. 84 ± 3. 46) and ( 18. 59 ± 2. 41) U·L^(-1);the levels of serum suppressor of cytokine signaling 3 mRNA were 0. 11 ± 0. 02 and 0. 26 ± 0. 04;activated partialthromboplastin time were ( 33. 72 ± 5. 59 ) and ( 39. 58 ± 5. 76 ) s;prothrombin time w

关 键 词：干扰素注射液 阿司匹林肠溶片 羟基脲片 真性红细胞增多症 JAK2V617F基因突变 

分 类 号：R97[医药卫生—药品]