地西他滨联合HAG方案治疗骨髓增生异常综合征的疗效分析  

Efficacy Analysis of Decitabine Combined with HAG Regimen in the Treatment of Myelodysplastic Syndromes

作　　者：祝春玲 隋丽丽 张晓丽 王海芸 ZHU Chunling;SUI Lili;ZHANG Xiaoli;WANG Haiyun(Department of Hematology,Zhucheng People´s Hospital,Weifang,Shandong Province,262200 China)

机构地区：[1]诸城市人民医院血液病科,山东潍坊262200

出　　处：《中外医疗》2023年第22期39-42,59,共5页China & Foreign Medical Treatment

摘　　要：目的评估地西他滨(decitabine,DAC)+HAG方案应用在骨髓增生异常综合征(myelodysplastic syn⁃drome,MDS)患者中的疗效。方法依据随机数表法,随机选取2020年3月—2023年6月诸城市人民医院的58例MDS患者划分为对照组(纳入29例,采用HAG方案)、观察组(纳入29例,采用DAC+HAG方案),评价组间临床疗效、T淋巴细胞亚群、血清炎性因子[白细胞介素-10(interleukin-10,IL-10)、白细胞介素-13(inter⁃leukin-13,IL-13)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)]、可溶性转铁蛋白(soluble transfer⁃rin,sTfR)、生长分化因子11(growth differentiation factor 11,GDF11)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、药物不良反应(adverse drug reaction,ADR)。结果治疗后,较对照组,观察组客观缓解率、疾病控制率、CD_(4)^(+)/CD_(8)^(+)、CD_(4)^(+)T细胞、IL-10、IL-13更高,CD_(8)^(+)T细胞、TNF-α、sTfR、GDF11、VEGF更低,差异有统计学意义(P<0.05);观察组ADR(20.69%)与对照组(10.34%)比较,差异无统计学意义(χ^(2)=0.526,P>0.05)。结论对MDS患者采用DAC+HAG方案,可以增强疗效,调控炎性因子、T淋巴细胞亚群及VEGF表达,改善造血功能,加之安全性良好,值得推广。Objective To evaluate the efficacy of decitabine(DAC)+HAG regimen in patients with myelodysplastic syndrome(MDS).Methods Based on the randomized numerical table method,58 MDS patients in Zhucheng People´s Hospital from March 2020 to June 2023 were randomly selected and divided into the control group(29 cases were included,and the HAG program was adopted)and the observation group(29 cases were included,and the DAC+HAG program was adopted).Clinical efficacy,T lymphocyte subsets,serum inflammatory factors[interleukin-10(IL-10),interleukin-13(IL-13),tumor necrosis factor-alpha(TNF-α)],soluble transferrin(sTfR),growth differentiation factor 11(GDF11),vascular endothelial growth factor(VEGF),and adverse drug reactions(ADR)were evaluated between groups.Results After treatment,compared with the control group,the objective remission rate,disease control rate,CD_(4)^(+)/CD_(8)^(+),CD_(4)^(+)T cells,IL-10,IL-13 were higher,and CD_(8)^(+)T cells,TNF-α,sTfR,GDF11,VEGF were lower in the observation group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in terms of ADR between the observation group(20.69%)and the control group(10.34%)(χ^(2)=0.526,P>0.05).Conclusion The use of DAC+HAG regimen for MDS patients can enhance the efficacy,regulate the expression of inflammatory factors,T-lymphocyte subpopulations and VEGF,and improve hematopoietic function,coupled with a good safety profile,which is worthy of promotion.

关 键 词：地西他滨 HAG方案 骨髓增生异常综合征 T淋巴细胞亚群 

分 类 号：R4[医药卫生—临床医学]