达那唑、促红素、沙利度胺、阿法骨化醇四联疗法治疗骨髓增生异常综合征的效果观察

Effect of Four Combination Therapy of Danazol,Erythropoietin,Thalidomide and Alfacalcitol in the Treatment of Myelodysplastic Syndrome

目的:研究达那唑、促红素、沙利度胺、阿法骨化醇四联疗法治疗骨髓增生异常综合征的效果。方法:选取福建医科大学附属龙岩第一医院2018年12月-2020年12月治疗的74例骨髓增生异常综合征患者作为研究对象。采取随机信封法将患者分为对照组和研究组,各37例。对照组采用促红素、沙利度胺、阿法骨化醇三联疗法;研究组在对照组的基础上加用达那唑进行四联疗法治疗。比较两组的临床有效率、生活质量评分及炎症因子等指标。结果:治疗后,研究组的治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组的炎症因子参考指标白介素-13(IL-13)、白介素-10(IL-10)、干扰素γ(IFN-γ)比较,差异无统计学意义(P>0.05);治疗后,两组炎症因子指标水平均较治疗前改善,而且研究组IL-13水平明显高于对照组,IL-10、IFN-γ明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组的血清低氧诱导因子(HIF-1α)、血管内皮生长因子(VEGF)水平比较,差异无统计学意义(P>0.05);治疗后,两组的HIF-1α、VEGF指标较治疗前均下降,且研究组均显著低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组健康调查简表(SF-36)量表评分比较,差异均无统计学意义(P>0.05);治疗后,两组SF-36评分较治疗前均改善,且研究组的评分显著高于对照组,差异均有统计学意义(P<0.05)。结论:达那唑、促红素、沙利度胺、阿法骨化醇四联疗法治疗骨髓增生异常综合征的效果显著,可有效改善患者血常规指标及生活质量,抑制体内炎症因子水平,可有效减少感染机会,延长生命期,安全性好。

Objective:To study the effect of Danazol,Erythropoietin,Thalidomide and Alfacalcidol in the treatment of myelodysplastic syndrome.Method:A total of 74 patients with myelodysplastic syndrome treated in Longyan First Hospital Affiliated to Fujian Medical University from December 2018 to December 2020 were selected as the research objects.The patients were divided into control group and study group according to the random envelope method,37 cases in each group.The control group was treated with Erythropoietin,Thalidomide and Alfacalcidol,and the study group was treated with Danazol on the basis of the control group.The clinical effective rate,quality of life score and inflammatory factors were compared between the two groups.Result:After treatment,the effective rate in the study group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).There were no significant differences in the levels of interleukin-13(IL-13),interleukin-10(IL-10),interferon-γ(IFN-γ)between the two groups before treatment(P>0.05).After treatment,the levels of inflammatory factors in both groups were improved compared with those before treatment,and the level of IL-13 in the study group was significantly higher than that in the control group,and the levels of IL-10,IFN-γwere significantly lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of serum hypoxia inducible factor(HIF-1α)and vascular endothelial growth factor(VEGF)between the two groups(P>0.05).After treatment,the HIF-1α,VEGF in the two groups were decreased compared with those before treatment,and the indexes in the study group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in the MOS item short from health survey(SF-36)scores between the two groups(P>0.05).After treatment,the scores of SF-36 in the two groups were improved compared with those before treatment,and the score in the study group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion:The combined therapy of Danazol,Erythropoietin,Thalidomide and Alfacalcitol is effective in the treatment of myelodysplastic syndrome.It can effectively improve the blood routine indexes and quality of life,inhibit the level of inflammatory factors,effectively reduce the chance of infection,prolong life and have good safety.