沙利度胺对急性白血病患者疗效及bFGF、VEGF水平的影响

Efficacy of Thalidomide in Patients with Acute Leukemia and Its Effect on bFGF and VEGF Levels

目的研究沙利度胺治疗急性白血病的疗效,及对碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)的影响。方法选取104例急性白血病患者作为研究对象,随机将其等分为两组,其中一组给予常规化疗方案治疗,为常规化疗组,另一组给予常规化疗方案加沙利度胺治疗,为沙利度胺组。比较两组治疗前后促血管生长因子、淋巴细胞、免疫球蛋白的变化,对比两组治疗有效性和安全性。结果治疗前,两组bFGF、VEGF水平差异无统计学意义(P>0.05),治疗后两组促血管生长因子水平不同程度地降低,且沙利度胺组bFGF、VEGF均低于常规化疗组,差异有统计学意义(P<0.05)。治疗前,辅助性T17(Th17)、自然杀伤细胞(NK)比率表达差异无统计学意义(P>0.05)。治疗后两组Th17细胞比率不同程度地升高,且沙利度胺组高于常规化疗组;常规化疗组NK细胞比率降低,沙利度胺组NK细胞比率升高,沙利度胺组高于常规化疗组,差异有统计学意义(P<0.05)。治疗前,IgA、IgB和IgM表达差异无统计学意义(P>0.05),治疗后两组免疫球蛋白水平不同程度地降低,且沙利度胺组IgA、IgG、IgM均高于常规化疗组,差异有统计学意义(P<0.05)。沙利度胺组治疗有效率(88.46%)高于常规化疗组(75.00%),差异有统计学意义(P<0.05);不良事件发生率(80.77%)和常规化疗组(76.92%)相近,差异无统计学意义(P>0.05)。结论沙利度胺临床疗效显著,安全性高,可有效调控急性白血病患者的细胞生长因子,提高其免疫功能。

Objective To study the clinical efficacy of Thalidomide in the treatment of acute leukemia,and to explore the effect of Thalidomide on the levels of basic fibroblast growth factor(b-FGF)and vascular endothelial growth factor(VEGF).Methods 104 patients with acute leukemia were randomly divided into two groups.Conventional chemotherapy group was treated with conventional chemotherapy,Thalidomide group was treated with conventional chemotherapy plus Thalidomide.The changes of cell growth factor,lymphocyte and immunoglobulin were compared between the two groups before and after treatment,and the efficacy and safety of the two groups were compared.Results Before treatment,there was no statistically significant difference in the levels of bFGF and VEGF between the two groups(P>0.05),but after treatment,the levels of bFGF and VEGF in the two groups decreased to different degrees,and the bFGF and VEGF in the Thalidomide group were lower than those in the conventional chemotherapy group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the expression of lymphocytes(Th17,NK cell ratio)between the two groups(P>0.05).After treatment,the ratio of Th17 cells in the two groups increased to different degrees,and the Thalidomide group was higher than the conventional chemotherapy group.The ratio of NK cells in the conventional chemotherapy group decreased,while the ratio of NK cells in the Thalidomide group increased,and the ratio of NK cells in the Thalidomide group was higher than that in the conventional chemotherapy group,with statistical significance(P<0.05).Before treatment,there was no statistical significance in the expression of IgA,IgG and IgM between the two groups(P>0.05).After treatment,the levels of IgA,IgG and IgM in the Thalidomide group decreased to different degrees,and the IgA,IgG and IgM in the Thalidomide group were higher than those in the conventional chemotherapy group,with statistical significance(P<0.05).The effective rate of Thalidomide group(88.46%)was higher than that of conventional chemotherapy group(75.00%),and the difference was statistically significant(P<0.05).The incidence of adverse events(80.77%)was similar to that of conventional chemotherapy group(76.92%),and the difference was not statistically significant(P>0.05).Conclusion Thalidomide has significant clinical eficacy and high safety.It can effectively regulate the cell growth factor of patients with acute leukemia and improve their immune function.