地西他滨治疗骨髓增生异常综合征的疗效及对CDH1和P15甲基化、生存质量的影响  

Efficacy of decitabine in the treatment of myelodysplastic syndrome and its influence on CDH1,P15 methylation and quality of life

作　　者：王友君 李素欣 冯丽倩 王苗 李栋梁 WANG Youjun;LI Suxin;FENG Liqian;WANG Miao;LI Dongliang(Department of Hematology,Shijiazhuang People's Hospital,Shijiazhuang 050000,Hebei,China;Fourth Department of Radiotherapy and Chemotherapy,Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei,China)

机构地区：[1]石家庄市人民医院血液内科,河北石家庄050000 [2]河北省沧州中西医结合医院放化疗四科,河北沧州061000

出　　处：《中南医学科学杂志》2024年第5期772-775,共4页Medical Science Journal of Central South China

基　　金：河北省医学科学研究课题(20221711)。

摘　　要：目的 探讨地西他滨治疗骨髓增生异常综合征(MDS)的疗效及对钙黏附分子1(CDH1)和P15甲基化水平、生存质量的影响。方法 选择75例MDS患者,按治疗方法分为对照组(37例,CAG化疗)和观察组(38例,CAG化疗+地西他滨)。比较两组临床疗效、血小板计数、血红蛋白、白细胞计数、CDH1、P15甲基化水平、生存质量、不良反应发生率。结果 观察组客观缓解率高于对照组(P<0.05)。两组不良反应总发生率比较差异无显著性(P>0.05)。与治疗前比较,治疗后两组血小板计数、血红蛋白、白细胞计数升高;CDH1、P15甲基化水平、情绪功能、伴随情况、主要症状、认知程度、满意程度评分降低;且观察组较对照组变化更显著(P<0.05)。结论 地西他滨治疗MDS疗效显著,下调体内甲基化水平,改善生存质量;且不会增加不良反应发生风险。Aim To investigate the efficacy of decitabine in the treatment of myelodysplastic syndrome(MDS) and its effects on the methylation level of calcium adhesion molecule 1(CDH1) and P15 and quality of life.Methods Seventy-five MDS patients were randomly divided into control group(37 cases with CAG chemotherapy) and observation group(38 cases with CAG chemotherapy + decitabine).The clinical efficacy,platelet count,hemoglobin,white blood cell count,methylation levels of CDH1 and P15,quality of life and incidence of adverse reactions were compared between the two groups.Results The objective remission rate of observation group was higher than that of control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Compared with before treatment,the platelet count,hemoglobin,and white blood cell count increased in both groups after treatment;the methylation levels of CDH1 and P15,emotional function,accompanying conditions,main symptoms,cognitive level,and satisfaction score decrease;and the changes in the observation group were more significant than those in the control group(P<0.05).Conclusion Decitabine is effective in the treatment of MDS to downregulate the methylation level in vivo and improve the quality of life.It does not increase the risk of adverse reactions,and has a high clinical reference value.

关 键 词：地西他滨 MDS 疗效 甲基化 生存质量 

分 类 号：R551.3[医药卫生—血液循环系统疾病]