放血疗法联合羟基脲、阿司匹林对真性红细胞增多症患者的影响

Effect of Blood Letting Therapy Combined with Hydroxycarbamide and Aspirin on Patients with Polycythemia Vera

目的:探究放血疗法联合羟基脲、阿司匹林治疗真性红细胞增多症患者的效果。方法:选取内蒙古科技大学包头医学院第一附属医院2021年1月—2022年1月收治的60例真性红细胞增多症患者,根据掷硬币法随机分成观察组和对照组,各30例。对照组患者给予羟基脲联合放血疗法治疗,观察组患者在对照组基础上联合小剂量阿司匹林治疗。比较两组临床疗效、凝血功能、血液学指标、不良反应、骨髓增殖性肿瘤总症状评估量表(MPN-SAF-TSS)评分及血栓发生率。结果:观察组治疗总有效率较对照组更高,血栓发生率较对照组更低(P<0.05)。治疗前,两组凝血功能指标比较,差异均无统计学意义(P>0.05);治疗后,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)较治疗前均有所延长,且观察组的APTT、PT、TT均较对照组更长,两组纤维蛋白原(FIB)水平均降低,且观察组FIB水平显著低于对照组(P<0.05)。治疗前,两组红细胞(RBC)、血红蛋白(Hb)、血小板计数(PLT)、白细胞(WBC)水平比较,差异均无统计学意义(P>0.05);治疗后,两组RBC、Hb、PLT、WBC水平均有所降低,且观察组RBC、Hb、PLT、WBC水平均显著低于对照组(P<0.05)。治疗后,观察组MPN-SAF-TSS评分低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:放血疗法联合羟基脲、阿司匹林治疗真性红细胞增多症,不仅可以改善患者的凝血功能和血液学指标,而且能够提高治疗效果,降低患者的血栓发生率,且不增加不良反应。

Objective:To explore the effect of blood letting therapy combined with Hydroxycarbamide and Aspirin in the treatment of polycythemia vera.Method:A total of 60 patients with polycythemia vera admitted to the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from January 2021 to January 2022 were selected and randomly divided into observation group and control group according to coin toss method,with 30 cases in each group.Patients in the the control group were treated with Hydroxycarbamide combined with blood letting therapy,and patients in the the observation group were treated with low-dose Aspirin based on the control group.The clinical efficacy,coagulation function,hematological indexes,adverse reactions,myeloproliferative neoplasm symptom assessment form total symptom score(MPN-SAF-TSS)and incidence of thrombus were compared between the two groups.Result:The total effective rate of the observation group was higher than that of the control group,and the incidence of thrombus was lower than that of the control group(P<0.05).Before treatment,there were no significant differences in coagulation function indexes between the two groups(P>0.05);after treatment,the activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)in both groups were longer than those before treatment,and the APTT,PT and TT in the observation group were longer than those in the control group,and the fibrinogen(FIB)levels of both groups were decreased,and the FIB level of observation group was significantly lower than that of control group(P<0.05).Before treatment,there were no significant differences in red blood cell(RBC),hemoglobin(Hb),platelet(PLT)and white blood cell(WBC)levels between the two groups(P>0.05);after treatment,RBC,Hb,PLT and WBC levels in both groups were decreased,and RBC,Hb,PLT and WBC levels in observation group were significantly lower than those in control group(P<0.05).After treatment,MPN-SAF-TSS score of observation group was lower than that of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Blood letting therapy combined with Hydroxycarbamide and Aspirin in the treatment of polycythemia vera can not only improve the coagulation function and hematological indexes of patients,but also improve the therapeutic effect,reduce the incidence of thrombus in patients,and do not increase adverse reactions.