标准剂量与大剂量阿糖胞苷在急性白血病巩固治疗中的应用有效性

Efficacy of Standard Dose and High Dose Cytarabine in Consolidation Therapy of Acute Leukemia

目的分析急性白血病巩固治疗中不同剂量阿糖胞苷的效果。方法非随机选取2019年12月—2020年12月滕州市中心人民医院收治的86例急性白血病巩固期患者为研究对象。按阿糖胞苷的使用剂量分为有标准组、大剂量组,各43例。标准组使用标准剂量,大剂量组使用大剂量。比较两组临床指标、不良反应及远期疗效。结果大剂量组白细胞、血小板减少时间短于标准组,中位存活时间长于标准组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P均>0.05)。两组随访1年时生存率比较,差异无统计学意义(P>0.05)。大剂量组随访2、3年时生存率分别为85.71%(30/35)、60.00%(18/30),均高于标准组的51.52%(17/33)、39.41%(5/17),差异有统计学意义(χ^(2)=8.498、4.063,P均<0.05)。结论大剂量阿糖胞苷治疗急性白血病巩固期患者,短期内不良反应少,远期生存率高,能迅速调节白细胞代谢状态,达到较好急性白血病巩固期康复效果。

Objective To analyze the effect of different doses of cytarabine in consolidation therapy of acute leukemia.Methods Eighty-six patients with acute leukemia in the consolidation stage admitted to Tengzhou Central People′s Hospital from December 2019 to December 2020 were non-randomly selected as study subjects.According to the dose of cytarabine used was divided into having standard group and high dose group,both forty-three cases.The standard group used the standard dose,and the high dose group used the high dose.Compared the clinical indexes,adverse reactions and long-term efficacy of the two groups.Results The high-dose group had shorter leukopenia and thrombocytopenia time and longer median survival time than the standard group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(all P>0.05).There was no statistically significant difference between the two groups in the survival rate at 1 year of follow-up(P>0.05).The survival rates at 2 and 3 years of follow-up in the high-dose group were 85.71%(30/35)and 60.00%(18/30),respectively,which were higher than 51.52%(17/33)and 39.41%(5/17)in the standard group,and the differences were statistically significant(χ2=8.498,4.063,both P<0.05).Conclusion High-dose cytarabine treatment of patients with acute leukemia in the consolidation phase has fewer short-term adverse effects and higher long-term survival,and can rapidly regulate the metabolic state of leukocytes to achieve better recovery in the consolidation phase of acute leukemia.