儿童朗格汉斯细胞组织细胞增生症临床研究

Clinical Study on Langerhans Cell Histiocytosis in Children

目的:探讨观察儿童朗格汉斯细胞组织增生症临床治疗方案和效果。方法:选取我院2007年4月-2014年11月收治的儿童朗格汉斯细胞组织细胞增生症65例,按随机数字表法分为观察组(32例)和对照组(33例)。对照组给予朗格汉斯细胞组织细胞增生症-Ⅲ(LCH-Ⅲ)治疗方案,观察组给予难治性2008方案。观察两组患者临床疗效、复发率、并发症、生存率。结果:观察组完全缓解率显著高于对照组(P<0.05),而两组患者的复发率和总有效率之间的差异无统计学意义(P>0.05);两组治疗后9个月、12个月、24个月生存率差异无统计学意义(P>0.05);观察组不良反应发生率为9.38%,对照组为24.24%,观察组稍低于对照组,但两组差异无统计学意义(P>0.05)。结论:采用难治性2008方案治疗儿童朗格汉斯细胞组织细胞增生症较LCH-Ⅲ方案疗效更佳,且远期生存率明显改善,还可减少不良反应,值得在临床治疗中推广应用。

Objective： To explore the clinical treatment programs and effects of Langerhans cell histiocytosis in children. Methods： 65 children with Langerhans cell histiocytosis who were treated in our hospital from April 2007 to November 2014 were selected, they were divided into observation group （with 32 cases） and control group （with 33 cases） according to the random number table method. The control group were given the Langerhans Cell Histiocytosis-III （LCH-III）treatment program, and the observation group were given refrac- tory 2008 program. The clinical effects, recurrence rates, complications and survival rates of the two groups were observed. Results： The complete remission rate in the observation group was significantly higher than that in the control group （P〈0.05）. The recurrence rate and total effective rate of two groups were no significant difference （P〉0.05）. There were no significant differences in the survival rates at 9 months, 12 months and 24 months after treatment （P〉0.05）. The incidence rate of adverse reactions in the observation group was 9.38%, while the control group was 24.24%, of which the observation group was slightly lower than that of the control group, but there was no significant difference between the two groups （P〉0.05）. Conclusion： The refi＇actory 2008 program in the treatment of children with Langerhans cell histiocytosis is better than LCH-regimen, with the long-term survival rate improved significantly, which can reduce the adverse reactions, and it is worth popularizing and applying in clinical treatment.