摘要
目的:评价反应停治疗原发性骨髓纤维化的临床疗效并测定反应停治疗前后血清血管内皮生长因子水平的变化。方法:选择2003-02/2006-01桂林医学院附属医院血液科收治的原发性骨髓纤维化患者21例,男8例,女13例;年龄49～78岁。按患者及家属意愿分为两组:治疗组11例,服用反应停,先从100mg/d(分为两次服)开始、1周后逐渐增加剂量至400～600mg/d;对照组10例,服用康力龙6mg/d、强的松30mg/d及马法兰2.5mg/次(3次/周)。两组均需连续用药至少6个月,分别在用反应停治疗前、治疗后3个月和6个月测定患者血清血管内皮生长因子水平;并按《血液病诊断及疗效标准》中的标准评估临床疗效,分为基本缓解、部分缓解、进步和无效;同时观察药物的不良反应。结果:21例患者全部进入结果分析。①两组患者治疗效果比较:治疗组总有效率明显高于对照组总有效率(64%,17%,χ2=87.36,P<0.001)。②两组治疗前后血清中血管内皮生长因子浓度:治疗组治疗3个月和6个月后血中血管内皮生长因子水平明显低于治疗前[(120.47±9.68),(99.87±10.43),(171.67±14.79)ng/L,P<0.05和0.01];对照组治疗3个月和6个月后血中血管内皮生长因子水平与治疗前比较无明显差别[(162.49±11.23),(162.33±12.26),(164.35±12.74)ng/L,P>0.05]。③不良事件及副反应:治疗组11例患者中,2例使用反应停后出现嗜睡、3例出现双下肢轻度水肿、5例有便秘现象,但都能耐受。结论:反应停治疗原发性骨髓纤维化疗效较好、毒副作用小;反应停可明显降低原发性骨髓纤维化患者血清血管内皮生长因子水平。
AIM： To evaluate the clinical effectiveness of thalidomide in the treatment of myelofibrosis, and test the levels of the serum vascular endothelial growth factor （VEGF） of myelofibrosis patients before and after thalidomide treatment.
METHODS： A total of 21 myelofibrosis patients including 8 males and 13 females and aged 49-78 years were selected from the Department of Hematology, Affiliated Hospital of Guilin Medical College from February 2003 to January 2006. According to the wills of patients and their relatives, the eligible subjects was divided into two groups： ①Treatmcnt group （n=11）： The patients took thalidomide at the dose of 100 mg per day （twice） initially and increased to 400-600 mg per day one week later;② Control group （n=10）： The patients were administrated with 6 mg stanozolol daily, 30 mg prednisone daily and melphalan （2.5 mg once, three times one week）. Both groups were treated for successive 6 months, and the levels of serum VEGF were tested at 0, 3 and 6 months after treatments respectively; Referring to the Diagnosis of Hematologic Diseases and Criteria of Therapy Effects, the clinical curative effects of patients were evaluated as fundamentally released, partly released, advanced and ineffective; Meanwhile the side effects were observed in both groups.
RESULTS ： Totally 21 patients were involved in the result analysis.① Comparison of curative effects in two groups： The total effective rate was significantly higher in treatment group than in control group （64%, 17%, X：=87,36, P 〈 0.001）. ②Comparison of serum VEGF levels before and after treatment： In treatment group, the VEGF levels were markedly decreased after 3 and 6 months treatment [（120.47±9.68）, （99.87±10.43）, （171.67±14.79） ng/L, P 〈 0.05, 0.01]; There was insignificant difference in the VEGF levels of control group before and after 3 and 6 months treatment [（162.49±11.23）, （162.33±12.26）, （164.35±12.74） ng/L, P 〉 0.05]. ③Adverse event and sid
出处
《中国临床康复》
CSCD
北大核心
2006年第33期59-61,共3页
Chinese Journal of Clinical Rehabilitation
