地西他滨联合半量HAG化疗方案对老年急性髓系白血病患者疗效、环氧化酶2、碱性成纤维细胞生长因子及血管内皮生长因子的影响

发布时间：2019-01-22 18:55

【摘要】：目的探讨地西他滨联合半量HAG(高三尖杉酯碱+阿糖胞苷+粒细胞-巨噬细胞集落刺激因子)化疗方案对老年急性髓系白血病(AML)患者疗效、安全性、环氧化酶(COX)-2、碱性成纤维细胞生长因子(bFGF)及血管内皮生长因子(VEGF)的影响。方法 80例老年AML患者按照随机数字表法分为观察组(地西他滨+半量HAG化疗)和对照组(HAG方案),每组40例。比较两组治疗效果、不良反应、血清COX-2、bFGF及VEGF水平。结果对照组总缓解率明显低于观察组(χ~2=10.476,P=0.005)。治疗过程中,对照组出现血液系统不良反应(11例)明显高于观察组(4例,χ~2=4.021,P=0.045);观察组肺部感染、恶心呕吐、发热不良反应发生率明显高于对照组(χ~2=4.588,P=0.032;χ~2=7.040,P=0.008;χ~2=5.000,P=0.025);在肝功能异常、心功能不全及脱发方面,两组无明显差异(χ~2=0.157,P=0.692;χ~2=0.213,P=0.644;χ~2=0.721,P=0.396)。化疗2个疗程后,观察组COX-2、bFGF及VEGF水平均明显低于对照组(t=9.362,P=0.000;t=8.746,P=0.000;t=2.705,P=0.004)。结论地西他滨联合半量HAG化疗方案可以显著降低老年AML患者VEGF含量,提高化疗效果,但是治疗过程中增加了消化道不良反应的发生,临床应用时应严密观察患者病情变化,给予有效的预防措施。
[Abstract]:Objective to investigate the efficacy, safety and cyclooxygenase (COX) 2 of desitabine combined with half dose HAG (homoharringtonine cytarabine cytosine macrophage colony stimulating factor) regimen in elderly patients with acute myeloid leukemia (AML). Effects of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Methods 80 elderly patients with AML were randomly divided into two groups: observation group (HAG chemotherapy) and control group (HAG regimen) with 40 cases in each group. The therapeutic effects, adverse reactions, serum COX-2,bFGF and VEGF levels were compared between the two groups. Results the total remission rate in the control group was significantly lower than that in the observation group (蠂 ~ 2 + 10.476 P < 0.005). In the course of treatment, the adverse reaction of blood system in the control group (11 cases) was significantly higher than that in the observation group (4 cases, 蠂 ~ 24.021). The incidence of pulmonary infection, nausea, vomiting and fever in the observation group was significantly higher than that in the control group (蠂 ~ 2 ~ 2 ~ (4.588) P 0.032; 蠂 ~ 2 ~ 2 = 7.040 ~ 0. 008; 蠂 ~ 2 = 5.000 ~ 0. 025). There was no significant difference in abnormal liver function, cardiac insufficiency and alopecia between the two groups (蠂 ~ 2 = 0.157 ~ 0. 692; 蠂 ~ (2) = 0.213 ~ 1 ~ 0. 644; 蠂 ~ 2 ~ 2 = 0.721 ~ 1 ~ 0. 396). After two courses of chemotherapy, the levels of COX-2,bFGF and VEGF in the observation group were significantly lower than those in the control group (t 9.362). Conclusion Dietabine combined with half-dose HAG regimen can significantly reduce the VEGF content and improve the chemotherapy effect in elderly patients with AML, but the adverse reactions of digestive tract are increased in the course of treatment, and the changes of patients' condition should be observed closely in clinical application. Give effective precautions.
【作者单位】：嘉兴市第一医院血液科;
【分类号】：R733.71

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