摘要
目的:比较沙利度胺联合不同剂量地西他滨治疗骨髓增生异常综合征(MDS)的疗效,及对患者Th17和Th22细胞水平的影响。方法:采用回顾性分析方法,收集我院2013年4月7日~2017年2月28日100例MDS患者资料,均使用常规剂量沙利度胺联合地西他滨治疗,对出现不良反应患者的沙利度胺治疗剂量予以适度调整。根据地西他滨剂量的不同,将患者分为分为低剂量组和高剂量组。低剂量组静注地西他滨剂量为12 mg·m-2·d-1,连用8 d为1个疗程,治疗39个疗程;高剂量组静注地西他滨剂量为20 mg·m-2·d-1,连用5 d为1个疗程,治疗49个疗程。比较治疗后两组疗效、血细胞数量、发生血细胞减少的疗程数、第1~2个疗程中出现的粒细胞缺乏平均时间、感染情况及Th17和Th22细胞水平的变化等。结果:治疗后两组患者的疗效相当(P>0.05),治疗前后两组患者血细胞数量差异无统计学意义(P>0.05)。低剂量组血红蛋白、中性粒细胞和血小板减少疗程数少于高剂量组(P<0.05);低剂量组在第1~2个疗程出现粒缺后的平均持续时间少于高剂量组(P<0.05);低剂量组感染发生率低于高剂量组(P<0.05)。治疗后,低剂量组Th17和Th22细胞水平较治疗前均有降低(P<0.05),高剂量组仅Th17细胞水平降低(P<0.05),Th22细胞水平无明显变化(P>0.05),且治疗后低剂量组的Th17和Th22细胞水平低于高剂量组(P<0.05)。结论:分别使用沙利度胺联合高剂量和低剂量地西他滨,对患者的疗效大致相当,且对血细胞数量无显著影响;沙利度胺联合低剂量低西他滨对降低Th17和Th22细胞水平的作用更为突出,具有更小的骨髓细胞毒性和更高的安全性。
Objective： To investigate curative effect of thalidomide combined with different doses decitabine in the treatment of myelodysplastic syndrome（ MDS） and their influence to Th17 cell and Th22 cell. Methods： 100 cases of MDS patients who were treated in our hospital from April 1,2013 to February 28,2017 were retrospectively analyzed and divided into low dose group and high dose group according to different doses of thalidomide combined with decitabine. Conventional dose thalidomide was given to all patients and dosage adjustment should be taken to some patients with adverse reactions.The patients in the low-dose group were given 12 mg·m^-2·d^-1,tid for 8 d as one treatment course,39 courses of treatment; The patients in the high-dose group were given 20 mg·m^-2·d^-1,tid for 5 d as one treatment course,49 courses of treatment; After treatment,the curative effect,the number of blood cells,the number of courses of blood cell reduction,the average time of granulocyte deficiency in first to second courses,infection and the changes of Th17 and Th22 cell levels were compared between the two groups. Results： There was no significant difference in curative effect between the two groups after treatment（ P〉0. 05）; The number of blood cells before and after treatment showed no significant difference（ P〈0. 05）; the course of hemoglobin,neutrophile granulocyte and platelet reduction in the low dose group was less than that in the high-dose group（ P〈0. 05）; The average duration time of granulocyte deficiency in first to second courses in the low dose group was less than that in the high-dose group（ P〈0. 05）; The incidence of infection in low dose group was lower than that in high dose group（ P〈0. 05）; After treatment,the levels of Th17 and Th22 cells in the low dose group were lower than those before treatment（ P〈0. 05）,while in the high dose group,only the Th17 cell level was decreased（ P〈0. 05）,the level of Th22 cells showed no significant changes（ P〉0. 05）. After tr
作者
刘双娇
张艳彬
孟伟
韩潇
Liu Shuangjiao;Zhang Yanbin;Meng Wei;Han Xiao(Department of Hematopathology,Peking Union Medical College Hospital,Beijing 100730,China)
出处
《药物流行病学杂志》
CAS
2018年第9期594-598,共5页
Chinese Journal of Pharmacoepidemiology
