不同蒽环类药物为基础的诱导方案治疗成人初治急性髓系白血病的疗效观察-内科学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要·························································································· 1 英文摘要······························································································· 3 英文缩写·········································································································5 研究论文 不同蒽环类药物为基础的诱导方案治疗成人初治急性髓系白 血病的疗效观察 前言 · · ··· ·· ·· ··· ·· ·· ··· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ··· ·· ·· ·· 6 材料与方法······················································································ 7 结果····································································································· 9 附表····························································································· 13 讨论··························································································· 18 结论····································································································· 21 参考文献····················································································· 22 综述 影响急性髓系白血病预后的免疫遗传多因素研究进展···················25 致谢········································································································ 34 个人简历····················································································· 35 中 中 文 摘 要 PAGE 2万方数据 PAGE 2 万方数据 不同蒽环类药物为基础的诱导方案治疗成人初治急性髓系白血 病的疗效观察 摘 要 背景：急性髓系白血病（acute myeloid leukemia,AML）是骨髓造血 干/祖细胞起源的恶性疾病，是一个具有高度异质性的疾病群，多数病例 发病急，病情重，预后差，如不及时治疗中位生存期仅 3 个月。目前， 经典的 AML 诱导缓解方案是以蒽环类药物联合阿糖胞苷的“3+7”方案， 同时包括成份输血、及时有效的抗生素使用等强有力支持治疗使 AML 预后得到较大改善。国内外研究显示，AML 患者治疗完全缓解率可达 65 ％-85％。作为新型蒽环类药物，去甲氧柔红霉素与柔红霉素一样，成为 急性髓系白血病的常用诱导药物，但目前国内外对两种药物的疗效差异 尚无明确定论。另一方面，因国人经济耐受力不同，近年来，国产去甲 氧柔红霉素（艾诺宁）在临床上已被广泛使用，其治疗效果、毒副作用 与进口去甲氧柔红霉素（善唯达）的疗效差异尚无明确定论。 目的：观察并分析去甲氧柔红霉素( IDA) （国产、进口）与柔红霉 素( DNR) 分別联合阿糖胞苷化疗治疗成人初治非 M3 型急性髓系白血病 的疗效及毒副作用。 方法：回顾性分析河北医科大学第二医院血液科就诊的 282 例初治 AML 患者的临床资料，初诊时间 2012 年 7 月 1 日～2015 年 11 月 30 日。 其中应用 IA 方案（去甲氧柔红霉素(8-10)mg/m2/d，d1-3；阿糖胞苷(100-200) mg/m