摘要
目的探讨沙利度胺联合达那唑治疗骨髓增生异常综合征(MDS)疗效的评估指标。方法选取医院2018年1月至2020年5月收治的MDS患者112例,均予沙利度胺片联合达那唑胶囊口服治疗3个月,根据疗效分为有效组(91例)和无效组(21例)。比较两组患者的白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、骨髓原始细胞比例及T淋巴细胞免疫球蛋白黏液素3(Tim3)、白细胞介素32(IL-32)、程序性死亡因子-1/程序性死亡因子配体-1(PD-1/PD-L1)水平。采用Pearson相关性分析预测治疗前后外周血Tim3,IL-32,PD-1/PD-L1之间及其分别与WBC,Hb,PLT和骨髓原始细胞比例间的相关性,评价上述外周血指标对该治疗方案疗效的评估价值。结果与无效组比较,有效组患者治疗后的WBC,Hb,PLT均显著升高,骨髓原始细胞比例显著降低(P<0.05),且外周血Tim3,IL-32,PD-1/PD-L1水平均显著降低(P<0.05)。治疗前后,患者外周血Tim3分别与IL-32,PD-1/PD-L1水平呈显著正相关,IL-32与PD-1/PD-L1水平呈显著正相关,外周血Tim3,IL-32,PD-1/PD-L1水平分别与WBC,Hb,PLT水平呈显著负相关,与骨髓原始细胞比例呈显著正相关,外周血Tim3,IL-32,PD-1/PD-L1水平与沙利度胺联合达那唑治疗MDS的疗效显著相关(P<0.05)。外周血Tim 3,IL-32,PD-1/PD-L1联合评估两药联用治疗MDS可能无效的药-时曲线下面积(0.885)相对三者单一评估时更大,敏感度、特异度分别为76.19%,92.31%。结论沙利度胺联合达那唑治疗MDS,可有效下调外周血Tim3,IL-32,PD-1/PD-L1水平,综合分析3个指标有助于评价沙利度胺联合达那唑治疗MDS的疗效。
Objective To investigate the evaluation indicators for the efficacy of thalidomide combined with danazol in the treatment of myelodysplastic syndrome(MDS).Methods A total of 112 patients with MDS admitted to the hospital from January 2018 to May 2020 were selected,all of whom were treated with Thalidomide Tablets combined with Danazol Capsules orally for three months.They were divided into the effective group(91 cases)and the ineffective group(21 cases)based on the efficacy.The white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),ratio of bone marrow blasts,T cell immunoglobulin mucin 3(Tim3),interleukin-32(IL-32),programmed death-1/programmed death-ligand 1(PD-1/PD-L1)levels in the two groups were compared.Pearson correlation analysis was used to predict the correlation among peripheral blood Tim3,IL-32 and PD-1/PD-L1 before and after treatment,as well as their correlation with WBC,Hb,PLT and the ratio of bone marrow blasts.The application value of the above peripheral blood indicators in the efficay analysis was evaluated.Results Compared with those in the ineffective group,the WBC,Hb and PLT levels in the effective group significantly increased after treatment,the ratio of bone marrow blasts significantly decreased(P<0.05),and the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels significantly decreased(P<0.05).Before and after treatment,the patients′peripheral blood Tim3 showed a significantly positive correlation with IL-32 and PD-1/PD-L1 levels respectively,and IL-32 showed a significantly positive correlation with PD-1/PD-L1 level respectively(P<0.05).Before and after treatment,the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels showed a significantly negative correlation with WBC,Hb and PLT levels,and a significantly positive correlation with the ratio of bone marrow blasts respectively(P<0.05).Before and after treatment,the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels showed a significant correlation with the efficacy of thalidomide combined with danazol in the treatment of MDS(P<0.05)
作者
刘焰
李国妍
陈超
LIU Yan;LI Guoyan;CHEN Chao(Department of Pharmacy,Heze Hospital of Traditional Chinese Medicine,Heze,Shandong,China 274000)
出处
《中国药业》
CAS
2023年第24期128-133,共6页
China Pharmaceuticals
