脾多肽注射液联合R-CHOP方案治疗弥漫大B细胞淋巴瘤的近中期疗效

Short-term and medium-term efficacy of lienal polypeptide injection and R-CHOP on diffuse large B-cell lymphoma

目的探讨脾多肽注射液联合R-CHOP方案治疗弥漫大B细胞淋巴瘤(DLBCL)的近中期疗效。方法抽取2014年1月至2018年1月晋城市人民医院收治的DLBCL患者61例,随机分为两组,对照组30例,予以R-CHOP方案治疗;观察组31例,予以脾多肽注射液联合R-CHOP方案治疗。比较两组临床疗效、不良反应发生率、生存质量、生存率,治疗前后外周血T淋巴细胞(CD3^+、CD4^+、CD4^+/CD8^+、CD8^+)、血清血管内皮细胞生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)水平。结果两组治疗总有效率比较,差异未见统计学意义(P>0.05);观察组白细胞减少、血小板减少、骨髓抑制、血红蛋白减少发生率低于对照组(P<0.05);观察组疗程结束后CD3^+、CD4^+、CD4^+/CD8^+高于对照组,CD8+低于对照组(P<0.05);疗程结束后,两组血清VEGF、bFGF水平较治疗前下降(P<0.05);随访3个月,观察组生存质量高于对照组(P<0.05);随访18个月,两组生存率比较差异未见统计学意义(P>0.05)。结论R-CHOP方案单独及联合脾多肽注射液治疗DLBCL,疗效确切,对抑制患者新血管生成、改善远期生存率方面均具有一定效果,但脾多肽注射液联合R-CHOP方案能有效改善DLBCL患者机体免疫功能,降低其不良反应发生率,提高生存质量。

Objective To investigate the short-term and medium-term effects of lienal polypeptide injection combined with R-CHOP regimen on patients with diffuse large B-cell lymphoma(DLBCL).Methods A total of 61 patients with DLBCL in Jincheng People’s Hospital from January 2014 to January 2018 were randomly divided into two groups,and the 30 patients in control group were treated with R-CHOP regimen;31 patients in observation group were treated with lienal polypeptide injection combined with R-CHOP regimen.The clinical effect,incidence of adverse reactions,quality of life,survival rate,the levels of peripheral blood T lymphocytes(CD3^+,CD4^+,CD4^+/CD8^+,CD8^+),serum vascular endothelial growth factor(VEGF),and basic fibroblast growth factor(bFGF)before and after treatment were compared between the two groups.Results There was no significant difference in the total effective rate of treatment between the two groups(P>0.05);the incidence of leukopenia,thrombocytopenia,bone marrow suppression,and hemoglobin reduction in the observation group were lower than those in the control group(P<0.05);CD3+,CD4+,CD4+/CD8+in observation group were higher than those in control group,and CD8+was lower than that in control group after treatment(P<0.05);after treatment,the levels of serum VEGF and bFGF in both groups were lower than those before treatment(P<0.05);follow-up for 3 months,the quality of life in observation group was higher than that in control group(P<0.05);after 18 months of follow-up,there was no significant difference in survival rates between the two groups(P>0.05).Conclusions R-CHOP regimen alone and in combination with spleen peptide injection have certain effects in treatment of DLBCL are effective,they have a certain effect on inhibiting angiogenesis and improving long-term survival rate,however,lienal polypeptide injection combined with R-CHOP scheme can effectively improve the immune function of DLBCL patients,reduce the incidence of adverse reactions,and improve quality of life.