探討三氧化二砷聯合沙利度胺聯合治療骨髓增生異常綜合征的療效

朱翠霞

[摘要] 目的 對在骨髓增生異常綜合征的治療中應用三氧化二砷和沙利度胺聯合治療的效果進行分析和研究。方法 便利選擇該院收治的骨髓增生異常綜合征患者共計70例作為該次研究的納入對象，選取時間段為2017年1月—2019年6月，按照隨機數字表法將這些患者劃分為聯合用藥組和單一用藥組，每組35例。采用沙利度胺對單一用藥組患者進行治療，在此基礎上，聯合應用三氧化二砷治療聯合用藥組患者，對兩組患者的治療效果進行分析和比較。結果 單一用藥組中有8例完全緩解、10例部分緩解、9例穩定、8例無效，共計達到了51.4%的總有效率，聯合用藥組中有15例完全緩解、9例部分緩解、7例穩定、4例無效，共計達到了68.6%的總有效率，聯合用藥組的總有效率明顯高于單一用藥組，組間差異有統計學意義（χ2=8.735，P<0.05）。單一用藥組中共計有1例腹瀉、2例便秘、1例肝功能損害，共計達到了11.4%的不良反應發生率，聯合用藥組中共計有1例腹瀉、1例便秘、2例肝功能損害、1例上呼吸道感染，共計達到了14.3%的不良反應發生率，聯合用藥組的不良反應發生率與單一用藥組相比略高，差異無統計學意義（χ2=0.395，P>0.05）。結論 在骨髓增生異常綜合征的臨床治療中采用氧化二砷和沙利度胺聯合治療具有很好的效果，而且安全性更好。

[關鍵詞] 骨髓增生異常綜合征;三氧化二砷;沙利度胺;聯合用藥

[Abstract] Objective To analyze and study the effect of arsenic trioxide and thalidomide combined treatment in the treatment of myelodysplastic syndromes. Methods A total of 70 patients with myelodysplastic syndromes treated in the hospital were convenient selected as the subjects of this study. The period of time was from January 2017 to June 2019. These patients were divided into a combination drug group and single-dose group according to the random number table method， with 35 patients in each group. The thalidomide was used to treat patients in the single drug group. Based on this， arsenic trioxide was used in combination with the patients in the drug group to analyze and compare the treatment effects of the two groups of patients. Results Eight patients in the single-medicine group had complete remission， 10 patients had partial remission， 9 patients were stable， 8 patients were ineffective， and a total effective rate of 51.4% was achieved. 15 patients in the combination group had complete response， 9 patients had partial response， 7 cases were stable and 4 cases were ineffective， reaching a total effective rate of 68.6%. The total effective rate of the combined drug group was significantly higher than that of the single drug group， and the difference was statistically significant（χ2=8.735， P<0.05）. There were 1 case of diarrhea， 2 cases of constipation， and 1 case of liver function impairment in the monotherapy group， with a total incidence of adverse reactions of 11.4%. The combined group had 1 case of diarrhea， 1 case of constipation， and 2 cases of liver function impairment， 1 case of upper respiratory tract infection， a total of 14.3% of adverse reactions occurred. The incidence of adverse reactions in the combined drug group was slightly higher than that in the single drug group， but it was found to have no statistically significance after experience （χ2=0.395， P>0.05）. Conclusion The combined treatment of arsenic oxide and thalidomide in clinical treatment of myelodysplastic syndrome has good effect and better safety.