维奈克拉联合去甲基化药物在不宜接受标准化疗的AML患者中的应用研究  

Application of vinaikra in combination with demethylation drugs in AML patients who are not eligible for standard chemotherapy

作　　者：李霞[1] 葛文军[1] 刘喜 王丽 马飞 LI Xia;GE Wen-jun;LIU Xi(Department of Hematology,the Fifth People's Hospital of Datong,Datong Shanxi 037006,China)

机构地区：[1]大同市第五人民医院血液科,山西大同037006

出　　处：《临床和实验医学杂志》2024年第23期2474-2478,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省重点研发计划项目(编号:201903D321093);大同市重点研发计划项目(编号:2017101)。

摘　　要：目的观察维奈克拉联合去甲基化药物在不宜接受标准化疗的急性髓系白血病(AML)患者中的应用效果。方法前瞻性选取2020年1月至2023年12月在大同市第五人民医院住院治疗的AML患者80例作为研究对象,治疗前经评估,患者均不宜接受标准化疗。根据信封法将患者分为对照组和研究组,每组各40例。对照组患者接受阿扎胞苷单药治疗,研究组患者接受维奈克拉联合阿扎胞苷治疗。比较两组的治疗效果;记录治疗前、治疗4个周期后两组患者的血象指标(白细胞计数、血红蛋白、血小板计数)、淋巴细胞亚群水平;并记录治疗期间两组的不良反应发生情况;对患者进行2年随访,记录两组患者的生存情况。结果研究组的治疗有效率为82.50%,高于对照组(50.00%),差异有统计学意义(P<0.05)。治疗4个周期后,两组患者的白细胞计数均低于治疗前,血红蛋白及血小板计数均较治疗前升高,且研究组的白细胞计数为(7.12±1.45)×10^(9)/L,低于对照组[(8.23±1.87)×10^(9)/L],血红蛋白及血小板计数分别为(135.50±2.00)g/L、(114.96±1.23)×10^(9)/L,均高于对照组[(122.00±1.50)g/L、(106.68±1.74)×10^(9)/L],差异均有统计学意义(P<0.05)。治疗4个周期后,两组患者的CD3+、CD4+水平均较治疗前升高,CD8+水平均较治疗前降低,且研究组的CD3+、CD4+水平分别为(64.55±3.18)%、(45.58±2.46)%,均高于对照组[(57.36±3.12)%、(37.45±2.15)%],CD8+水平为(22.38±1.02)%,低于对照组[(25.49±1.38)%],差异均有统计学意义(P<0.05)。两组发生非血液不良反应及血液不良反应情况比较,差异均无统计学意义(P>0.05)。研究组的平均生存时间、中位生存时间均高于对照组,差异均有统计学意义(P<0.05)。结论维奈克拉联合去甲基化药物在不宜接受标准化疗的AML患者中可以提高治疗有效率,改善患者的血象指标和淋巴细胞亚群水平,并有助于提高患者的生存时间,且未明显增加�Objective To observe the application of venecra combined with demethylation drugs in patients with acute myeloid leukemia(AML)unfavorable for standard chemotherapy.Methods A total of 80 patients with AML who were hospitalized in the Fifth People's Hospital of Datong from January 2020 to December 2023 were prospectively selected as the research objects.After evaluation before treatment,all patients were not suitable for standard chemotherapy.According to the envelope method,they were divided into the control group and the study group,with 40 cases in each group.The control group received cytarabine monotherapy,and the study group received venecra combined with normethyl drug(cytarabine single agent).The therapeutic effects of the two groups were compared.The hemogram indexes(white blood cell count,hemoglobin,platelet count)and lymphocyte subsets of the two groups were recorded before and after 4 cycles of treatment.The adverse reactions of the two groups during the treatment were recorded.The patients were followed up for 2 years,and the survival of the two groups was recorded.Results The effective rate of treatment in the study group was 82.50%,which was higher than that in the control group(50.00%),and the difference was statistically significant(P<0.05).After 4 cycles of treatment,the white blood cell count of the two groups were lower than those before treatment,and the hemoglobin and platelet count were higher than those before treatment.The white blood cell count of the study group was(7.12±1.45)×10^(9)/L,which was lower than that of the control group[(8.23±1.87)×10^(9)/L],the hemoglobin and platelet count were(135.50±2.00)g/L and(114.96±1.23)×10^(9)/L,which were higher than those of the control group[(122.00±1.50)g/L,(106.68±1.74)×10^(9)/L],the differences were statistically significant(P<0.05).After 4 cycles of treatment,the levels of CD3+and CD4+in the two groups were higher than those before treatment,and the levels of CD8+were lower than those before treatment,the levels of CD3+and CD4+in the

关 键 词：急性髓系白血病 维奈克拉 去甲基化药物 疗效 

分 类 号：R73[医药卫生—肿瘤]