白血病患者西达本胺联合阿糖胞苷治疗的有效性及对患者不良反应发生的影响

Effectiveness of chidamide combined with cytarabine in the treatment of leukemia patients and its influence on the occurrence of adverse reactions in patients.

目的分析白血病患者西达本胺联合阿糖胞苷治疗的有效性及对患者不良反应发生的影响。方法前瞻性选取2016年10月至2018年10月琼海市人民医院住院治疗的98例急性髓系白血病患者,根据随机数字表法分组,单药组49例患者采纳阿糖胞苷治疗,联药组49例患者采纳西达本胺联合阿糖胞苷治疗,治疗6个疗程。比较2组患者临床疗效,血清可溶性细胞间黏附分子-1(sICAM-1)、血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)水平、生存率、不良反应发生率。结果联药组患者临床治疗总有效率为89.80%,高于单药组的61.22%,差异有统计学意义(P<0.05)。治疗6个疗程后,联药组患者血清sICAM-1、VEGF水平为(241.26±9.62)ng/mL、(71.26±6.82)ng/L,均低于单药组[(385.26±12.11)ng/mL、(108.26±9.64)ng/L],血清TGF-β1水平为(39.66±6.82)ng/mL,高于单药组[(18.62±3.28)ng/mL],差异均有统计学意义(P<0.05)。联药组1、2年生存率为71.43%、53.06%,均高于单药组(40.82%、26.53%),差异均有统计学意义(P<0.05)。联药组(14.29%)与单药组(12.24%)不良反应发生率比较,差异无统计学意义(P>0.05)。结论西达本胺联合阿糖胞苷可有效提高急性髓系白血病患者生存率,降低血清sICAM-1、VEGF水平,上调血清TGF-β1水平,且不良反应较少。

Objective To analyze the effectiveness of chidamide combined with cytarabine in patients with leukemia and its influence on the occurrence of adverse reactions in patients.Methods From October 2016 to October 2018,98 patients with acute myeloid leukemia who were hospitalized in Qionghai People's Hospital were prospectively selected and divided into 2 groups according to the random number table method.The 49 patients in single drug group were received cytarabine therapy,the 49 patients in combination drug group were received chidamide combined with cytarabine,6 courses of treatment.The clinical efficacy,serum soluble intercellular adhesion molecule-1(sICAM-1),vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1)levels,survival rate,and incidence of adverse reactions between the two groups were compared.Results The total clinical effective rate of patients in the combined drug group was 89.80%,which was higher than 61.22%in the single drug group,and the difference was statistically significant(P<0.05).After 6 courses of treatment,the serum sICAM-1 and VEGF levels of patients in the combination group were(241.26±9.62)ng/mL and(71.26±6.82)ng/L,which were lower than those in the single agent group[(385.26±12.11)ng/mL,(108.26±9.64)ng/L],the serum TGF-β1 level in the combination group was(39.66±6.82)ng/mL,which was higher than that in the single-agent group[(18.62±3.28)ng/mL],the differences were statistically significant(P<0.05).The 1 and 2 years survival rates of the combined drug group were 71.43%and 53.06%,which were higher than those of the single-drug group of 40.82%and 26.53%,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the combined drug group(14.29%)and the single drug group(12.24%)(P>0.05).Conclusion Chidamide combined with cytarabine can effectively improve the survival rate of patients with acute myeloid leukemia,reduce serum sICAM-1 and VEGF levels,and increase serum TGF-β1 levels with fewer adverse reactions.