三氧化二砷和阿糖胞苷联合治疗骨髓增生异常综合征38例疗效观察.docVIP

三氧化二砷和阿糖胞苷联合治疗骨髓增生异常综合征38例疗效观察 　　[摘要] 目的 观察三氧化二砷与阿糖胞苷联合治疗骨髓增生异常综合征的临床疗效。 方法 将我院确诊的76例骨髓增生异常综合征患者随机分为治疗组和对照组，每组各38例。治疗组给予阿糖胞苷（Ara-c）+三氧化二砷（As2O3）治疗。对照组采用传统的HA方案，三尖杉酯碱（H）和阿糖胞苷（A）治疗。两组患者均给予相同的支持治疗，即血红蛋白＜70 g/L，血小板＜30×109/L，输注血小板悬液或新鲜血；有感染者给予抗细菌、抗病毒及抗霉菌药物治疗；同时，注意保护肝、肾功能。两组患者均治疗3个疗程。 结果 治疗组总有效率为89.47%，对照组总有效率为71.05%，两组总有效率比较差异有统计学意义（P ＜ 0.05）。两组患者治疗血清血管内皮生长因子（VEGF）水平与治疗前比较，均明显下调，差异均有高度统计学意义（P ＜ 0.01）；治疗后，治疗组VEGF下调明显优于对照组，两组比较差异有高度统计学意义（P ＜ 0.01）。 结论 三氧化二砷与阿糖胞苷联合治疗能够提高骨髓增生异常综合征患者三系血细胞，使骨髓原始细胞数减少，改善血液学反应，且耐受性高，不良反应少，是一种有效的骨髓增生异常综合征治疗方法。 　　[关键词] 骨髓增生异常综合征；三氧化二砷；阿糖胞苷 　　[中图分类号] R551.3[文献标识码] A[文章编号] 1673-7210（2012）03（c）-0080-03 　　Clinical observation on Arsenic Trioxide combined with Cytarabine in the treatment of 38 patients with myelodysplastic syndrome 　　GUO Tianjian GONG Junmei WU Bijia ZHANG Weimin 　　Department of Hematology, the 421th Hospital of PLA, Guangdong Province, Guangzhou 510310, China 　　[Abstract] Objective To observe the treatment effect of Arsenic Trioxide (As2O3) combined with Cytarabine (Ara-c) in the treatment of myelodysplastic syndrome (MDS). Methods 76 patients with definite MDS were randomly divided into the treatment group and the control group, with 38 cases in each group. In the treatment group, Ara-c combined with As2O3 was used; while in the control group, traditional HA (Harringtonine and Ara-c) regimen was selected. The same supportive treatment was given in each group, that was transfusing platelet suspension or fresh blood to those with platelet of 30×109/L or HB of 70 g/L; giving anti-bacterial, anti-viral and anti-fungal treatment when there was infection; meanwhile the liver and kidney function were took good care. The patients in both groups were treated for three courses. Results Comparing the treatment effect between the two groups, the total effective rate of the treatment group was 89.47%, while that of the control group was 71.05%; there was significant difference in the two groups (P 0.05). The vascular endothelial growth f