沙利度胺联合去甲基化治疗方案治疗老年人急性髓系白血病临床效果观察

The effects observation of thalidomide combined demethylation treatment for the elderly patients with acute myeloid leukemia

目的探讨沙利度胺联合去甲基化治疗方案治疗老年人急性髓系白血病的临床效果。方法选择2012年7月至2014年12月诊治的老年急性髓性白血病患者80例,根据随机抽签法分为治疗组与对照组各40例。对照组给予基于去甲基化的半量预激方案治疗,治疗组在对照组治疗的基础上给予加用沙利度胺治疗,治疗3个疗程。观察两组的治疗效果;血清碱性成纤维细胞成长因子(b FGF)、血管内皮生长因子(VEGF);预后生存时间。结果治疗后治疗组与对照组的总有效率分别为70.0%和45.0%,治疗组的总有效率高于对照组(P<0.05)。治疗组治疗后的血清b FGF和VEGF含量为213.33±35.33 pg/ml和2.04±0.21 ng/ml,而对照组分别为297.34±32.14 pg/ml和2.29±0.42ng/ml。治疗后两组血清b FGF和VEGF含量均较治疗前明显降低(P<0.05),且治疗组的血清VEGF和b FGF含量降低更明显(P<0.05)。随访至今,治疗组的生存期为28.45±11.73个月,明显长于对照组的19.87±12.45个月(P<0.05)。结论沙利度胺联合去甲基化治疗方案治疗老年人急性髓系白血病可有效调节血清VEGF和b FGF的水平,提高临床疗效,从而延长患者的生存时间。

Objective To investigate the effects of thalidomide combined demethylation treatment for the elderly patients with acute myeloid leukemia. Methods From July 2012 to December 2014, 80 elderly patients with acute myeloid leukemia patients for treatment were equally divided into the treatment group and control groups with 40 patients according to the random lottery law, the treatment group were given based demethylation of demethylation treatment, the treatment group were given the ethalidomide treatment on the basis of the control group. The three courses of treatment were observed. The therapeutic effect and prognosis of the two groups were observed, the serum fibroblast growth factor （bFGF） and vascular endo-thelial growth factor （VEGF） contents and the related mechanism was analyzed. Results After treatment, the total efficiency in the treatment group and the control group were 70. 0% and 45. 0% respectively, the total efficiency in the treatment group was significantly higher （ P 〈0. 0 5 ） . The serum bFGF and VEGF contents in the treatment group after treatment were 213. 33 ± 35.33 pg/ml and 2.04 ± 0. 21 ng/ml, while the control group were 297.34 ±32.14 pg/ml and 2.29 ±0. 42 ng/ml that compared before treatment were significant difference （ P 〈 0 .0 5 ） , while differences between groups were statistically significant （ P 〈0. 05 ）. The lifetime in the treatment group 28.45 ± 11.73 months were significantly more than the 19. 87± 12.45 months in the control group （ P 〈0.05） . Conclusion Thalidomide combined demethylation treatment for elderly patients with acute myeloid leukemia can effectively regulate the expression of VEGF and bFGF serum, improve the clinical efficacy, thereby it can prolong the survival time of patients.