不同诱导方案对成人急性髓系白血病的应用效果及安全性研究

目的探讨不同诱导方案对成人急性髓系白血病的应用效果及安全性。方法选取2014年1月至2018年12月于该院就诊的82例急性髓系白血病患者作为研究对象,将患者按不同诱导方案分为观察组与对照组,观察组(n=42)采用去甲氧柔红霉素联合阿糖胞苷治疗,对照组(n=40)采用柔红霉素联合阿糖胞苷治疗,分析两组患者的缓解率、总有效率和不良反应情况。结果观察组总有效率为83.33%,对照组总有效率为62.50%,观察组总有效率明显高于对照组,差异有统计学意义(P<0.05);两组治疗后血小板计数、血红蛋白4级患者均稍少于2~3级患者,中性粒细胞4级患者均稍低于2~3级患者,但观察组与对照组比较,血液学不良反应率差异无统计学意义(P>0.05);观察组心律失常、肝肾功能损伤、感染及发热、出血发生率稍低于对照组,但两组非血液学不良反应率差异无统计学意义(P>0.05)。结论去甲氧柔红霉素联合阿糖胞苷对成人急性髓系白血病患者,与柔红霉素联合阿糖胞苷治疗相比疗效更好,治疗后并无明显血液、非血液不良反应增加,安全性较好。

Study on the efficacy and safety of different induction regimens in adult patients with acute myeloid leukemia

Objective To investigate the effect and safety of different induction schemes in the treatment of adult acute myeloid leukemia(AML).Methods A total of 82 patients with AML who were treated in Dianjiang County Hospital of Traditional Chinese Medicine from January 2014 to December 2018 were selected as the research objects.The patients were divided into two groups according to different induction schemes.The patients in observation group(n=42)were treated with nordaunorubicin combined with cytarabine,and the patients in control group(n=40)were treated with daunorubicin combined with cytarabine,the remission rate,total effective rate and adverse reactions of the two groups were analyzed.Results The total effective rate in the observation group and the control group were 83.33%and 62.50%,the total effective rate in the observation group was significantly higher than that in the control group(P<0.05).After treatment,patients with platelet and hemoglobin grade 4 were slightly more than patients with grade 2-3 and patients with neutrophil grade 4 were slightly less than patients with grade 2-3 in the two groups,however the differences of adverse hematological reactions between the observation group and the control group were not significant(P>0.05).The adverse reaction rates of heart rate arrhythmia,liver and kidney function damage,infection fever and hemorrhage in the observation group were slightly lower than those in the control group,but the differences on the rate of non-hematological adverse reactions were not significant(P>0.05).Conclusion Compared with daunorubicin and cytarabine,the combination of nordaunorubicin and cytarabine is more effective in the treatment of adult patients with acute myeloid leukemia.After treatment,hemorrhage and non-hemorrhage adverse reactions don′t increase,and the safety is better.