两种去甲基化药物对骨髓增生异常综合征患者免疫功能及生存质量的影响

Effects of two demethylating drugs on immune function and quality of life in patients with myelodysplastic syndrome

目的探讨地西他滨与阿扎胞苷治疗骨髓增生异常综合征患者的效果及对免疫功能、生存率、生存质量的影响。方法选取2019年3月至2020年9月广西壮族自治区南溪山医院血液科收治的60例骨髓增生异常综合征患者进行研究,采用随机数字表法分为研究组和对照组,每组各30例。对照组予以阿扎胞苷治疗,研究组予以地西他滨治疗。比较两组患者治疗4个疗程后的总有效率、细胞免疫功能、体液免疫功能、1年生存率、不良反应总发生率及生存质量。结果治疗后,两组的总有效率比较,差异无统计学意义(P>0.05);研究组的细胞免疫水平、体液免疫水平低于治疗前和对照组,差异有统计学意义(P<0.05);研究组的1年生存率、生存质量高于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论地西他滨治疗骨髓增生异常综合征的疗效和不良反应与阿扎胞苷相当,可抑制细胞免疫和体液免疫功能,提高患者的近期生存率和生存质量。

Objective To investigate the efficacies of decitabine and azacitidine on patients withmyelodysplastic syndrome(MDS)and their impacts on immune function,survival rate and qualityof life(QoL).Methods A total of 60 MDS patients admitted to and treated in the Department ofHematology in Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2019 t0September 2020 were selected for study They were divided into the study group(n=30)and thecontrol group(n=30)according to the random number table method.The control group was treatedwith azacitidine,while the study group was treated with decitabine.The overall response rate,cellular immune function,humoral immune function,1-year survival rate,the total incidence rateof adverse reactions(ADRs)and QoL were compared between the two groups of patients after 4courses of treatment.Results After treatment,there was no statistically significant difference in theoverall response rate between the study group and the control group(PV0.05).The levels of cellularimmunity and humoral immunity in the study group were lower than those before treatment and thosein the control group,with statistically significant differences(P<0.05).The 1-year survival rateand QoL in the study group were higher than those in the control group,with statistically significantdifferences(P<0.05).There was no significant difference in the total incidence of adverse reactionsbetween the two groups(PV0.05).Conclusion The therapeutic efficacy and ADRs of decitabinein the treatment of MDS is equivalent to that of azacitidine,which can inhibit cellular and humoralimmune functions and improve the short-term survival rate and QoL of patients.