不同5-HT3受体拮抗剂对急性髓系白血病联合化疗所致恶心呕吐的预防作用

Effect of different 5-HT3 receptor antagonists on preventing chemotherapy-induced nausea and vomiting in patients with acute myeloid leukemia

目的分析不同5-羟色胺(5-HT)3受体拮抗剂对急性髓系白血病(AML)联合化疗所致恶心呕吐的预防作用。方法选择2020年9月至2023年1月濮阳市安阳地区医院血液科收治的72例急性髓系白血病患者为研究对象,采用随机数字表法分为对照组与观察组,每组36例。对照组使用托烷司琼治疗,观察组采用帕洛诺司琼治疗。观察两组治疗前后血清5-HT、多巴胺(DA)、呕吐、恶心症状分级及KPS评分。比较两组预防呕吐的疗效。结果治疗后,两组5-HT、DA水平均降低,KPS评分均上升,且观察组改变幅度大于对照组,差异有统计学意义(P<0.05)。治疗前,两组恶心、呕吐症状分级比较,差异未见统计学意义(P>0.05),治疗后,观察组恶心、呕吐分级显著好于对照组,预防呕吐的整体疗效显著好于对照组,差异有统计学意义(P<0.05)。两组化疗后24 h症状缓解比较,差异未见统计学意义(P>0.05),化疗48、72、120 h后观察组症状缓解显著好于对照组,差异有统计学意义(P<0.05)。结论与托烷司琼比较,帕洛诺司琼在预防AML患者化疗后恶心呕吐反应效果方面更好。

Objective To investigate the effect of different 5-hydroxytryptamine type 3(5-HT3)receptor antagonists on preventing chemotherapy-induced nausea and vomiting in patients with acute myeloid leukemia.Methods Seventy-two patients with acute myeloid leukemia in Anyang District Hospital from September 2020 to January 2023 were enrolled,and randomly classified into two groups,with 36 cases in each group.The control group was treated with tropisetron,while the observation group was treated with palonosetron.The levels of 5-HT,dopamine(DA),grading of vomiting and nausea symptoms and Karnofsky Performance Status(KPS)grade were observed.The efficacy of preventing vomiting between two groups were compared.Results After treatment,the levels of 5-HT and DA in both groups decreased,and the KPS scores increased,and the changes in the observation group were greater than those in the control group(P<0.05).Before treatment,there was no significant difference in the grades of nausea and vomiting between the two groups(P>0.05).After treatment,the grades of nausea and vomiting in the observation group were significantly better than those in the control group,the overall effect of preventing vomiting was significantly better than that of the control group(P<0.05).There was no significant difference in the remission of symptoms between the two groups at 24 hours after chemotherapy(P>0.05).The remission of symptoms in the observation group was significantly better than that in the control group at 48,72 and 120 hours after chemotherapy(P<0.05).Conclusions Compared with tropisetron,palonosetron has a better effect on preventing nausea and vomiting reactions in AML patients after chemotherapy.