芦可替尼联合西罗莫司治疗骨髓纤维化的疗效分析  

Efficacy of Ruxolitinib Combined with Sirolimus in the Treatment of Myelofibrosis

作　　者：陈园园[1] 张永晓[1] 王冬梅[1] CHEN Yuanyuan;ZHANG Yongxiao;WANG Dongmei(Dept.of Hematology,Harrison International Peace Hospital,Hebei Hengshui 053000,China)

机构地区：[1]哈励逊国际和平医院血液科,河北衡水053000

出　　处：《中国医院用药评价与分析》2025年第1期41-44,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省2021年度医学科学研究重点课题计划(No.20211210)。

摘　　要：目的:探讨芦可替尼联合西罗莫司治疗骨髓纤维化的疗效。方法:选取2018年1月至2023年6月于该院就诊并接受正规治疗的骨髓纤维化患者36例,根据用药情况分为对照组(采用芦可替尼治疗)19例、观察组(采用芦可替尼联合西罗莫司治疗)17例。观察西罗莫司对骨髓纤维化患者细胞因子、纤维化情况、疗效和生存情况的影响。结果:治疗后,观察组患者转化生长因子-β、血小板衍生生长因子和表皮生长因子水平较治疗前明显降低,且明显低于同期对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者骨髓纤维化程度明显优于治疗前,差异有统计学意义(P<0.05)。观察组患者的有总效率为88.24%(15/17),明显高于对照组的57.89%(11/19),差异有统计学意义(P<0.05)。治疗后,观察组患者赖氨酰氧化酶(LOX)和组织蛋白酶D(Cath-D)水平较对照组明显降低,差异均有统计学意义(P<0.05)。观察组患者的不良反应发生率为58.82%(10/17),与对照组(57.89%,11/19)比较,差异无统计学意义(P>0.05)。观察组患者的无进展生存期为32个月,较对照组(29个月)稍长,但差异无统计学意义(P>0.05)。结论:西罗莫司能显著降低细胞因子水平,从而改善患者的骨髓纤维化情况,降低LOX、Cath-D水平,明显提高疗效,改善患者的无进展生存期。OBJECTIVE:To probe into the efficacy of ruxolitinib combined with sirolimus in the treatment of myelofibrosis.METHODS:A total of 36 patients with myelofibrosis admitted into this hospital to receive standard treatment from Jan.2018 to Jun.2023 were extracted to be divided into 19 cases in control group(received ruxolitinib)and 17 cases in observation group(received ruxolitinib combined with sirolimus).The effects of sirolimus on cytokines,degree of myelofibrosis,efficacy and survival status of patients were observed.RESULTS:After treatment,the transforming growth factor-β,platelet-derived growth factor and epidermal growth factor of the observation group were significantly lower than those before treatment and those of the control group at the corresponding period,with statistically significant differences(P<0.05).After treatment,the degree of myelofibrosis of observation group was significantly better than that before treatment,with statistically significant difference(P<0.05).The total effective rate of observation group was 88.24%(15/17),significantly higher than 57.89%(11/19)of control group,with statistically significant difference(P<0.05).After treatment,the lysyloxidase(LOX)and cathepsin D(Cath-D)levels of observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).The incidence of adverse drug reactions of observation group was 58.82%(10/17),compared with 57.89%(11/19)in the control group,the difference was not statistically significant(P>0.05).The progression free survival of observation group was 32 months,slightly longer than 29 months of the control group,the difference was not statistically significant(P>0.05).CONCLUSIONS:Sirolimus can significantly decrease the cytokine levels,improve the myelofibrosis degree,reduce the LOX and Cath-D levels,and significantly promote the efficacy and progression-free survival.

关 键 词：骨髓纤维化 西罗莫司 芦可替尼 疗效 

分 类 号：R979.5[医药卫生—药品]