亚砷酸联合沙利度胺治疗骨髓增生异常综合征的效果研究

Effect of arsenious acid combined with thalidomide on patients with myelodysplastic syndromes

目的研究亚砷酸与沙利度胺合用在临床上治疗骨髓增生异常综合征(MDS)的效果。方法选取商丘市第一人民医院2017年5月收治的60例MDS患者,随机分为沙利度胺组(30例)和联合用药组(30例)。沙利度胺组给予沙利度胺治疗,联合用药组给予沙利度胺和亚砷酸治疗。观察并比较两组患者治疗前后血清指标[肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、血管内皮生长因子(VEGF)]、骨髓象、临床疗效及不良反应。结果联合用药组血清指标含量(TNF-α、IFN-γ、VEGF)分别为(932.45±177.33)ng/ml、(4.12±1.12)pg/ml、(141.85±25.33)ng/ml,显著低于沙利度胺组(1002.78±168.37)ng/ml、(7.11±1.22)pg/ml、(158.82±26.22)ng/ml(P<0.05)。骨髓象变化情况和治疗有效率[联合用药组83.33%、沙利度胺组60.00%]两组差异均有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论亚砷酸与沙利度胺合用治疗MDS患者有较佳临床疗效。

Objective To study the clinical effect of arsenious acid combined with thalidomide on 60 patients with myelodysplastic syndromes（ MDS）. Methods Totally 60 MDS patients treated in our hospital were randomly divided into thalidomide group（ 30 cases） and combined medication group（ 30 cases）. Thalidomide group was treated with thalidomide,while the combined medication group was treated with thalidomide and arsenious acid. The serum indexes [tumor necrosis factor-α（ TNF-α）,interferon-γ（ IFN-γ）,vascular endothelial growth factor（ VEGF） ],myelogram,clinical effects and adverse reactions were observed and compared between the two groups before and after treatment.Results The serum indexes（ TNF-α,IFN-γ,VEGF） in the combined medication group were respectively（ 932. 45 ± 177. 33） ng/m L,（ 4. 12 ± 1. 12） pg/m L and（ 141. 85 ± 25. 33） ng/m L which were significantly lower than those in the thalidomide group（ 1002. 78 ± 168. 37） ng/m L,（ 7. 11 ± 1. 22） pg/m L and（ 158. 82 ± 26. 22） ng/m L（ P〈 0. 05）. The change of myelogram in the combined medication group was 24（ 80） which was higher than that in the thalidomide group 13（ 43. 33）,and the effective rate in the combined medication group was 25（ 83. 33） which was higher than that in the thalidomide group 18（ 60）,their differences were statistically significant（ P〈 0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P〈 0. 05）. Conclusion Arsenious acid combined with thalidomide has better clinical effect on patients with MDS.