摘要
目的探究克拉屈滨、阿糖胞苷、粒细胞刺激因子(CLAG)方案联合门冬酰胺酶治疗急性白血病疗效及对患者凝血功能的影响。方法选取我院于2019年6月至2021年6月收治的难治或复发性急性髓性白血病(RR-AML)患者90例,按随机数字表法分为对照组45例与试验组45例。对照组给予CLAG方案治疗,试验组在对照组的基础上给予左旋门冬酰胺酶(L-Asp)进行联合治疗。观察比较2组患者的临床疗效;活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)水平;白细胞介素-6(IL-6)、肿瘤特异性生长因子(TSGF)水平及不良反应发生率。结果临床总有效率比较,试验组显著高于对照组(P<0.05);治疗后,2组患者的FIB、TSGF、IL-6均降低,且试验组显著低于对照组(P<0.05),APTT、PT均升高,且试验组显著高于对照组(P<0.05);不良反应发生率的试验组略高于对照组,但差异无统计学意义(P>0.05)。结论相比于单纯CLAG方案治疗,CLAG方案联合门冬酰胺酶治疗RR-AML疗效更好,但对凝血功能有一定影响,导致凝血功能障碍的风险更大,临床应用时需严密监测。
Objective To investigate the efficacy of CLAG regimen combined with asparaginase in the treatment of acute leukemia and its effect on coagulation function.Methods A total of 90 patients with refractory or relapsed acute myeloid leukemia(RR-AML)admitted to our hospital from June 2019 to June 2021 were selected and divided into control group(n=45)and experimental group(n=45)according to random number table method.The control group was given CLAG regimen,and the experimental group was given L-asparaginase(L-Asp)combined therapy on the basis of the control group.The clinical efficacy,the levels of activated partial thrombin time(APTT),prothrombin time(PT)and fibrinogen(FIB),interleukin-6(IL-6),tumor-specific growth factor(TSGF)level,the incidence of adverse reactions of the two groups of patients were observed and compared.Results Compared with control group,the total clinical effective rate of the experimental group was significantly higher(P<0.05).After treatment,the levels of FIB,TSGF and IL-6 in the two groups were decreased,and the experimental group was significantly lower than the control group(P<0.05).APTT and PT were increased,and the experimental group was significantly higher than the control group(P<0.05).The incidence of adverse reactions in the experimental group was slightly higher than that in the control group,but there was no statistical difference(P>0.05).Conclusion Compared with the simple CLAG regimen,the CLAG regimen combined with asparaginase has better efficacy in the treatment of RR-AML,but it has a certain impact on the coagulation function,leading to a greater risk of coagulation dysfunction,and it needs to be closely monitored in clinical application.
作者
卜广瑞
张艳敏
刘小五
Bu Guangrui;Zhang Yanmin;Liu Xiaowu(Department of Hematology,the First Hospital of Yulin City,Shaanxi 718000,China;不详)
出处
《山西医药杂志》
CAS
2022年第16期1823-1826,共4页
Shanxi Medical Journal
