IDA联合Ara-C治疗初发急性髓系白血病对血清sICAM-1、sVCAM-1以及淋巴细胞亚群的影响

Study on the effect of Daunorubicin combined with cytarabine in the treatment of primary acute myeloid leukemia in serum sICAM-1,sVCAM-1 and peripheral blood lymphocyte subsets

目的探讨去甲氧柔红霉素(IDA)联合阿糖胞苷(Ara-C)治疗初发急性髓系白血病对血清可溶性细胞间粘附分子-1(sICAM-1)、可溶性血管细胞黏附分子1(sVCAM-1)以及淋巴细胞亚群的影响。方法收集我院收治的成人初发急性髓系白血病患者68例,根据随机对照表分为对照组和实验组,各34例,实验组予以去甲氧柔红霉素联合阿糖胞苷方案治疗,第1~3日去甲氧柔红霉素8~12 mg·m^(-2)·d^(-1)静脉滴注,第1~7日阿糖胞苷150mg·m^(-2)·d^(-1)皮下注射;对照组为第1~3日予以柔红霉素45mg·m^(-2)·d^(-1)+10mL生理盐水静脉滴注,第1~7日阿糖胞苷150mg·m^(-2)·d^(-1)皮下注射,两组均治疗7日。治疗结束后对比分析两组患者的临床疗效及血清sICAM-1、sVCAM-1、T淋巴细胞亚群、铁蛋白、红细胞生成素(EPO)、肝细胞生长因子(HGF)、血管内皮生长因子(VEGF)水平变化和不良反应发生情况。结果治疗后两组患者血清sICAM-1、sVCAM-1水平下降(P<0.05),外周血CD3^+、CD4^+、CD4^+/CD8^+、CD16^+CD56^+水平升高(P<0.05),血清铁蛋白、EPO、HGF以及VEGF水平下降(P<0.05);与对照组相比,实验组临床总有效率较高,血清sICAM-1、sVCAM-1水平较低(P<0.05),外周血CD3^+、CD4^+、CD4^+/CD8^+、CD16^+CD56^+水平较高(P<0.05),血清铁蛋白、EPO、HGF以及VEGF水平较低(P<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论去甲氧柔红霉素联合阿糖胞苷对初发急性髓系白血病诱导缓解化疗效果显著,适宜临床推广应用。

Objective To investigate the effect of Daunorubicin combined with cytarabine in the treatment of primary acute myeloid leukemia in serum sICAM-1,sVCAM-1 and peripheral blood lymphocyte subsets.Methods 68 patients with primary acute myeloid leukemia patients were collected and randomly divided into control group and experimental group,34 cases each,the control group received daunorubicin 45 mg/m^2/d＋10 mL iv at the first 1-3 days,cytarabine 150 mg/m^2/d at 1-7 days,the experimental group received Daunorubicin 8-12 mg/m^2/d 1-3 days,cytarabine 150 mg/m^2/d at 1-7 days,2 groups were treated for 7 days.After the treatment,the clinical efficacy,levels of sICAM-1,sVCAM-1,T lymphocyte subsets,ferritin,EPO,HGF,VEGF and adverse reactions in two groups were compared.Results Compared with before treatment,levels of serum sICAM-1,sVCAM-1 in 2 groups decreased（P〈0.05）,peripheral blood CD3^＋,CD4^＋,CD4^＋/CD8^＋,CD16^＋CD56^＋ increased（P〈0.05）,serum ferritin,EPO,HGF and VEGF decreased（P〈0.05）.Compared with the control group,the clinical total effect rate in experimental group was higher than the control group,levels of serum sICAM-1,sVCAM-1 were lower（P〈0.05）,levels of peripheral blood CD3^＋,CD4^＋,CD4^＋/CD8^＋,CD16^＋CD56^＋ were higher（P〈0.05）,serum ferritin,EPO,HGF and VEGF were lower（P〈0.05）,there were no statistical significantly differences in adverse reactions between 2 groups（P〉0.05）.Conclusion The effect of Daunorubicin combined with cytarabine in the treatment of primary acute myeloid leukemia was significant effective,and it is suitable for clinical application.