沙利度胺、环孢素联合泼尼松治疗中低危骨髓增生异常综合征疗效及对患者Th17、Th22细胞的影响

Clinical Effect of Combination Therapy with Thalidomide,Cyclosporin A and Metacortandracin to Treat Myelodysplastic Syndrome and its Influence on Th17 and Th22 Cells

目的:观察沙利度胺、环孢素联合泼尼松(TCP方案)治疗中低危骨髓增生异常综合征(MDS)的临床疗效及其对患者Th17、Th22细胞水平的影响。方法:中低危MDS住院患者68例随机分为两组各34例。观察组采用TCP方案治疗,对照组单用环孢素治疗,共治疗12周。评估两组疗效与药品不良反应,比较两组患者治疗前后Th17、Th22细胞表达水平变化。结果:治疗12周后,观察组有效率64.71%高于对照组41.18%(P<0.05)。治疗后,观察组Th17、Th22细胞水平均较治疗前降低(P<0.05),对照组仅Th17细胞水平有所降低(P<0.05);且观察组Th17、Th22细胞水平均低于对照组(P<0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:TCP方案治疗中低危MDS安全、有效,且能够通过调节Th17和Th22细胞水平改善患者免疫功能。

Objective：To observe the effect of combination therapy（ TCP） with thalidomide,Cyclosporin A and metacortandracin to treat myelodysplastic syndrome（ MDS） and its influence on Th17 and Th22 cells. Methods：68 patients with MDS were divided into 2 groups randomly,each 34 patients. Patients in the observation group were treated with TCP,and patients in the control group were treated with Cyclosporin A,all the patients were treated for 12 weeks. The clinical effect,adverse drug reaction and Th17,Th22 cells expression level before and after treatment of the two groups were compared. Results：12 weeks after treatment,the clinical effective rate of observation group was higher than that of the control group（64. 71% vs. 41. 18%,P 〈0. 05）. After treatment,both the Th17 and Th22 cell level proportion of the observation group decreased significantly than before（ P 〈0. 05）,and the Th17 cell proportion of the control group decreased significantly（ P 〈0. 05）,and both the Th17 and Th22 cell proportion of the observation group were lower than those of the control group（ P 〈0. 05）. There was no significant different in the complication rate between group（ P 〉0. 05）. Conclusion：TCP regimen for low and medium risk MDS was safe,effective,and could adjust the level of Th17 and Th22 cells to improve patients＇ immune function.