伊马替尼联合重组人干扰素α-2b治疗加速期慢性髓性白血病患者的疗效及对血清MMP-2、SALL4 mRNA和AGP水平的影响  

Efficacy of imatinib combined with recombinant human interferonα-2b in patients with advanced chronic myeloid leukemia and its impacts on serum levels of MMP-2,SALL4 mRNA and AGP

作　　者：王晖[1] 李艳春 高秋英 张玎[1] 郑研 WANG Hui;LI Yan-chun;GAO Qiu-ying(Department of Hematology,Shaanxi Provincial People′s Hospital,Xi′an 710068,China)

机构地区：[1]陕西省人民医院血液科,西安710068 [2]西安国际医学中心医院血液病实验室,陕西710100

出　　处：《中国临床新医学》2023年第5期468-473,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：陕西省社会发展科技攻关项目(编号:2015SF131)。

摘　　要：目的探讨伊马替尼联合重组人干扰素α-2b(IFNα-2b)治疗加速期慢性髓性白血病(CML)患者的疗效及对血清基质金属蛋白酶-2(MMP-2)、婆罗双树样基因4(SALL4)mRNA和α1-酸性糖蛋白(AGP)水平的影响。方法招募2017年1月至2021年1月陕西省人民医院收治的加速期CML住院患者90例。采用随机数字表法将其分为观察组(采用伊马替尼联合IFNα-2b治疗,45例)和对照组(采用伊马替尼治疗,45例)。比较两组临床疗效和血清MMP-2、SALL4 mRNA和AGP水平以及不良反应发生情况。结果观察组治疗后获完全血液学缓解(CHR)的人数比例较对照组更高,整体疗效更优,差异有统计学意义(P<0.05)。两组治疗前血清白细胞介素-6(IL-6)、前列腺素E 2(PGE 2)、碱性磷酸酶(ALP)、MMP-2、SALL4 mRNA、AGP水平比较差异无统计学意义(P>0.05),治疗后IL-6、PGE 2、ALP、MMP-2、SALL4 mRNA、AGP水平均较治疗前显著降低(P<0.05),且观察组治疗后水平较对照组更低,差异有统计学意义(P<0.05)。观察组血液学不良反应发生率高于对照组[22.22%(10/45)vs 6.67%(3/45);χ2=4.406,P=0.039],两组非血液学不良反应发生率比较差异无统计学意义[6.67%(3/45)vs 4.44%(2/45);χ2=0.000,P=1.000],总不良反应发生率比较差异有统计学意义[28.89%(13/45)vs 11.11%(5/45);χ2=4.444,P=0.035]。结论伊马替尼联合IFNα-2b较单用伊马替尼治疗加速期CML疗效更佳,可降低患者血清MMP-2、SALL4 mRNA和AGP水平,但可能会增加患者血液学不良反应的发生风险。Objective To investigate the efficacy of imatinib combined with recombinant human interferonα-2b(IFNα-2b)in the treatment of advanced chronic myeloid leukemia(CML)and its impacts on serum levels of matrix metalloproteinase-2(MMP-2),spalt-like transcription factor 4(SALL4)mRNA andα1-acid glycoprotein(AGP).Methods Ninety inpatients with advanced CML who were admitted to Shaanxi Provincial People′s Hospital from January 2017 to January 2021 were recruited.The patients were divided into the observation group(treated with imatinib combined with IFNα-2b,45 cases)and the control group(treated with imatinib,45 cases).The clinical efficacy,and serum levels of MMP-2,SALL4 mRNA and AGP,and the occurrence of adverse reactions were compared between the two groups.Results The proportion of the patients who achieved complete hematological remission(CHR)after treatment in the observation group was higher than that in the control group,and the overall efficacy in the observation group was better,and the differences were statistically significant(P<0.05).There were no significant differences in the serum levels of interleukin-6(IL-6),prostaglandin E 2(PGE 2),alkaline phosphatase(ALP),MMP-2,SALL4 mRNA and AGP between the two groups before treatment(P>0.05).After treatment,the levels of IL-6,PGE 2,ALP,MMP-2,SALL4 mRNA and AGP were significantly decreased compared with those before treatment in the two groups(P<0.05),and the levels of the observation group after treatment were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of hematological adverse reactions in the observation group was higher than that in the control group[22.22%(10/45)vs 6.67%(3/45);χ^(2)=4.406,P=0.039].There was no significant difference in the incidence of non-hematological adverse reactions[6.67%(3/45)vs 4.44%(2/45);χ2=0.000,P=1.000]and there was significant difference in the total incidence of adverse reactions[28.89%(13/45)vs 11.11%(5/45);χ^(2)=4.444,P=0.035].Conclusion Imatinib combined w

关 键 词：伊马替尼 重组人干扰素α-2b 慢性髓性白血病 基质金属蛋白酶-2 婆罗双树样基因4 Α1-酸性糖蛋白 

分 类 号：R733.72[医药卫生—肿瘤]