急性早幼粒细胞白血病患者使用三氧化二砷维持治疗时对血小板聚集率的影响

Effect of Arsenic Trioxide Maintenance Treatment on Platelet Aggregation in Patients with Acute Promyelocytic Leukemia

目的研究急性早幼粒细胞白血病患者使用三氧化二砷维持治疗时对血小板聚集率的影响。方法抽选2012年1月至2014年1月在我院接受治疗达到完全缓解的急性早幼粒细胞白血病(APL)患者98例,随机数字表法分为观察组和对照组各49例,观察组以ATRA+砷剂维持治疗;对照组以ATRA+6-巯基嘌呤(6-MP)+甲氨蝶呤(MTX)维持治疗。比较两组患者治疗期间平均血小板聚集率及维持治疗时间,随访统计复发率、死亡率、无复发生存率、总生存率,观察不良反应发生情况。结果胶原、二磷酸腺苷(ADP)诱聚:观察组分别为(76.72±5.33)%、(81.43±8.30)%均显著低于对照组(89.46±6.29)%、(88.27±7.95)%(P<0.05)。两组患者复发率、死亡率、无复发生存率、总生存率比较无显著差异(P>0.05)。观察组维持治疗时间为(19±3)月低于对照组(27±4)月(P<0.05)。结论APL患者使用三氧化二砷维持治疗能抑制患者血小板聚集率。

Objective To study the effect of arsenic trioxide maintenance treatment on platelet aggregation in patients with acute promyelocytic leukemia( APL). Methods 98 patients with APL who received treatment and got complete remission in our hospital between January 2012 and January 2014 were selected and divided into observation group and control group by the random number table method,49 cases in each group. The observation group was given ATRA combined with arsenical maintenance treatment; The control group was given ATRA combined with 6-mercaptopurine( 6-MP) and methotrexate( MTX) maintenance treatment. The average platelet aggregation rate during treatment and duration of maintenance treatment were compared between the two groups. The recurrence rate,mortality,recurrence-free survival rate and overall survival rate were statistically analyzed. The incidence of adverse reactions was observed. Results Stimulated by collagen and adenosine diphosphate( ADP),the platelet aggregation test( PAg T) in the observation group[( 76. 72 ± 5. 33) %,( 81. 43 ± 8. 30) %]were significantly lower than those in the control group[( 89. 46 ±6. 29) %,( 88. 27 ± 7. 95) % ]( P < 0. 05). There were no significant differences in recurrence rate,mortality rate,recurrence-free survival rate,overall survival rate and between the two groups( P > 0. 05). The duration of maintenance treatment in the observation group[( 19 ± 3) months]was shorter than that in the control group[( 27 ± 4) months]( P < 0. 05). Conclusion The application of arsenic trioxide maintenance treatment in patients with APL can inhibit platelet aggregation.