亚砷酸联合全反式维甲酸治疗急性早幼粒细胞白血病的临床分析

目的探讨亚砷酸联合全反式维甲酸治疗急性早幼粒细胞白血病的临床效果。方法将本院2008年1月～2013年9月收治的64例急性早幼粒细胞白血病患者随机分为4组，每组各16例。联合组给予亚砷酸和全反式维甲酸进行双诱导治疗，亚砷酸组给予亚砷酸治疗，维甲酸组给予全反式维甲酸治疗，化疗组给予常规化疗治疗。结果联合组、亚砷酸组的所有患者（100％）完全缓解，无死亡病例，维甲酸组13例（81．2％）患者达到完全缓解，1例死亡，化疗组仅6例（37．5％）完全缓解，2例死亡，前3组的完全缓解率均显著高于化疗组（P〈0.05）；联合组患者用药至完全缓解的时间明显短于亚砷酸组、维甲酸组（P〈0.05）；联合组患者凝血指标恢复正常所用的时间短于亚砷酸组、维甲酸组（P〈0.05）；肝功能损伤情况：联合组最严重，亚砷酸组次之，维甲酸组较轻，化疗组最轻（P〈0.05），化疗组的胃肠道反应、皮肤损伤情况较严重，受影响患者明显多于其他3组（P〈0.05）。结论亚砷酸联合维甲酸治疗急性早幼粒细胞白血病短期效果显著，完全缓解率高，并可缩短患者的完全缓解时间。

Clinical analysis of arsenious acid and all-trans retinoic acid treating a- cute promyeleocytic leukemia

Objective To observe the clinical effect of arsenious acid combined with all-trans retinoic acid treating acute promyeleoeytie leukemia. Methods 64 cases with acute promyeleocytic leukemia treated in our hospital from January 2008 to September 2013 were selected and randomly divided into the four groups and there were 16 cases in each group. The combination group was treated with arsenious acid combined with all-trans retinoic acid of double induction therapy,the arsenious acid group was treated with arsenious acid,and the retinoic acid group was treated with all-trans retinoic acid,and the chemotherapy group was given the conventional chemotherapy treatment. Results All patients （100%） of the combination group and arsenious acid group were in complete remission,and there was no dead case,there were 13 cases （81.2%） with complete remission in the retinoic acid group,and there was 1 dead case.There were only 6 cases （37.5%） with complete remission in the chemotherapy groupand there were 2 dead cases.The complete remission rate of the former 3 groups was evidently higher than that of the chemotherapy group （P〈0.05）;the time Of medication to complete remission the combination group was evidently shorter than that in the arsenious acid group and the retinoic acid group （P〈0.05）;the time of coagulation indicators returned to normal for the combination group was shorter than that of the arsenious acid group and retinoic acid group （P〈0.05）;the damage of liver function：the combination group was the most severe,the second was the arsenious acid group and retinoic acid group and the chemotherapy group was the most light （P〈0.05）;gastro-intestinal tract response and skin injury of the chemotherapy group was more servere,and the affected patients in the chemotherapy group were significantly more than the other 3 groups （P〈0.05）. Conclusion Ar- senious acid and all-trans retinoic acid treating acute promyeleocytic leukemia not only had evident effect and high complete remission rate,but also can reduce the complete remission time of patients