去甲氧柔红霉素联合阿糖胞苷治疗急性髓细胞白血病疗效的系统评价

发布时间：2018-01-07 14:28

  本文关键词：去甲氧柔红霉素联合阿糖胞苷治疗急性髓细胞白血病疗效的系统评价　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： 去甲氧柔红霉素 柔红霉素 阿糖胞苷 系统评价 随机对照试验

【摘要】：目的：系统评价去甲氧柔红霉素(IDA)与柔红霉素(DNR)分别联合阿糖胞苷(Ara-C)对急性髓细胞白血病的诱导缓解疗效及安全性。方法：计算机检索PubMed(1966-2014)、MEDLINE(1990-2014)、CBM(1978-2014)、CNKI(1979-2014)、 Wanfang Data(1998-2014)、VIP(1991-2014)等数据库,收集IDA与DNR分别联合Ara-c治疗急性髓细胞白血病的随机对照试验(RCT),并追溯纳入研究的参考文献.有两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采取RevMan5.2软件进行系统评价分析。结果：共纳入13个RCT,4347例患者.系统评价分析结果显示：在治疗急性髓细胞白血病的总有效率[RR=1.18,95%CI(1.06,1.32),P=0.003]、显效率[RR=1.16,95%CI(1.07,1.27),h=0.0004]、复发率[RR=0.57,95%CI(0.34,0.94),P=0.03]方面去甲氧柔红霉组均优于柔红霉素组,血液学不良反应(1).骨髓幼稚细胞下降幅度[MD=13.02,95%CI(9.81,16.23),P0.00001]、(2).白细胞最低值[MD=-0.22,95%CI(-038,-0.07),P=0.004]、(3)两组白细胞达到最低水平时间方面[MD=-2.26,95%CI(-3.13,-1.40),P0.00001],去甲氧柔红霉素组对骨髓抑制更明显,在两组非血液学不良反应方面,两组差异无统计学意义(P0.05)。结论：现有证据显示,去甲氧柔红霉素联合阿糖胞苷组(IA)在治疗急性髓系白血病的有效率、缓解率、复发率方面优于柔红霉素联合阿糖胞苷组(DA)。并且发生药物不良反应较低,安全性相对较高,同时在患者预后方面也优于DA组。
[Abstract]:Objective: to evaluate the combination of normodaunorubicin (IDA) and daunorubicin (DNR) with cytarabine cytosine Ara-Crespectively. Methods: the efficacy and safety of induction and remission in acute myeloid leukemia were studied by computer search of PubMedus (1966-2014). MEDLINE (1990-2014 / CBM / 1978-2014 / CNKI 1979-2014). Wanfang data (1998-2014) and other databases. A randomized controlled trial of IDA and DNR combined with Ara-c in the treatment of acute myeloid leukemia was collected. According to the inclusion and exclusion criteria, two researchers independently screened the literature, extracted the data and evaluated the quality. Results: a total of 4347 patients with acute myeloid leukemia were included in this study. The results showed that the total effective rate in the treatment of acute myeloid leukemia was higher than that of the control group. [RRN 1.18 / 95 CIQ 1.06 / 1.32 / P0. 003]. [RRN 1.1695% CI1. 07 1. 27% 0.0004, recurrence rate 0. 0004. [The RRX 0.57 ~ 95CII 0.34 ~ 0.94% P0. 03 were better than the daunorubicin group. Hematological adverse reactions: decline of immature cells in bone marrow. [MDR 13.02 ~ 95CIQ 9.81 ~ 16.23% P0.00001] Leukocyte minimum value. [MDN-0.22% 95% CIQ -038U -0.07% P0. 004]) time of reaching the lowest level of white blood cells in the two groups. [MD-2.26 ~ 95% CI-3.13 + -1.40% (P0.00001), normodaunorubicin group had more obvious bone marrow suppression, in both groups non-hematological side effects. Conclusion: there is no significant difference between the two groups in the treatment of acute myeloid leukemia. Conclusion: the available evidence shows that normodaunorubicin combined with cytosine arabinoside group is effective and effective in the treatment of acute myeloid leukemia. The recurrence rate was better than that of daunorubicin combined with cytarabine group, and the adverse drug reaction was lower, the safety was higher, and the prognosis of the patients was better than that of DA group.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R733.71
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