去甲基化药物治疗中高危骨髓增生异常综合征的效果观察  

Effect of hypomethylating agents in the treatment ofintermediate-and high-risk myelodysplasia syndrome

作　　者：颜宗海 吴燕明[1] 丁刚[1] 李承君[1] 孙光宇 YAN Zonghai;WU Yanming;DING Gang;LI Chengjun;SUN Guangyu(Department of Hematology,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu,Anhui,238000)

机构地区：[1]安徽医科大学附属巢湖医院血液内科,安徽巢湖238000

出　　处：《实用临床医药杂志》2024年第5期75-78,84,共5页Journal of Clinical Medicine in Practice

基　　金：安徽省高等学校科学研究项目(2023AH053413)。

摘　　要：目的观察去甲基化药物(HMAs)治疗中高危骨髓增生异常综合征(MDS)患者的临床效果。方法回顾性选取58例中高危MDS患者作为研究对象,研究组25例患者采用阿扎胞苷或地西他滨行去甲基化治疗,对照组33例患者接受常规对症支持治疗,观察并比较2组患者的临床疗效、血常规指标水平、生存质量、不良反应发生情况等。结果治疗后,研究组完全缓解率、客观缓解率、疾病控制率均高于对照组,疾病进展率低于对照组,差异有统计学意义(P<0.05);研究组1年生存率为92.00%,高于对照组的75.76%,但差异无统计学意义(P>0.05)。治疗后,2组血红蛋白、白细胞、血小板水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组患者生存质量(躯体功能、认知功能、情绪功能、角色功能、社会功能)评分高于对照组,差异有统计学意义(P<0.05)。结论HMAs治疗对中高危MDS患者的临床疗效优于常规对症支持治疗,不仅能改善患者的生存质量,而且安全性良好。Objective To observe the clinical effect of hypomethylating agents(HMAs)in the treatment of patients with intermediate-and high-risk myelodysplastic syndrome(MDS).Methods A retrospective study was conducted in 58 patients with intermediate-and high-risk MDS.The study group(25 patients)received azacitidine or decitabine for hypomethylating treatment,while the control group(33 patients)received routine symptomatic supportive treatment.The clinical efficacy,hematologic parameters,quality of life,and adverse events were observed and compared between the two groups.Results After treatment,the complete remission rate,objective response rate,and disease control rate were higher in the study group than in the control group,while the disease progression rate was lower(P<0.05).The 1-year survival rate was 92.00%in the study group,which was higher than 75.76%in the control group,but the difference showed no statistically significant(P>0.05).After treatment,hemoglobin,white blood cell,and platelet levels were higher in both groups than before treatment,and were higher in the study group than in the control group(P<0.05).The total incidence of adverse events was lower in the study group than that in the control group(P<0.05).After treatment,the quality of life scores(physical function,cognitive function,emotional function,role function,and social function)were higher in the study group than those in the control group(P<0.05).Conclusion HMAs treatment is superior to routine symptomatic supportive treatment in patients with intermediate-and high-risk MDS,and not only improves the quality of life but also has good safety.

关 键 词：去甲基化药物 骨髓增生异常综合征 中高危 阿扎胞苷 地西他滨 生存质量 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R973[医药卫生—内科学] R319[医药卫生—临床医学]