小剂量地西他滨联合阿柔比星+阿糖胞苷+重组粒细胞集落刺激因子方案治疗骨髓增生异常综合征的效果分析

金梦迪 肖建红 王淡瑜

[摘要]目的 探讨分析小剂量地西他滨联合阿柔比星+阿糖胞苷+重组粒细胞集落刺激因子（CAG）方案治疗骨髓增生异常综合征的效果。方法 选取2011年10月～2018年10月我院收治的82例骨髓增生异常综合征患者作为研究对象，按随机数字表法分成研究组（n=41）和参照组（n=41）。参照组患者予以常规CAG方案治疗，研究组患者则采用小剂量地西他滨联合CAG方案进行治疗。比较两组患者的临床治疗效果，观察两组治疗后的不良反应发生情况。结果 研究组患者的治疗缓解率为78.05%，高于参照组的58.54%，差异有统计学意义（P<0.05）。两组的不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 骨髓增生异常综合征患者应用小剂量地西他滨联合CAG方案治疗，有助于提升患者的临床缓解率，且不会明显增加不良反应，安全性良好。

[关键词]骨髓增生异常综合征;预激化疗;地西他滨;不良反应

[中图分类号] R733.3          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0122-04

Effect analysis of low-dose Decitabine combined Arubicin + Cytarabine + Recombinant Granulocyte Colony Stimulating Factor programme in the treatment of myelodysplastic syndrome

JIN Meng-di   XIAO Jian-hong   WANG Dan-yu

Department of Hematology， Union Shenzhen Hospital of Huazhong University of Science and Technology， Guangdong Province， Shenzhen   518052， China

[Abstract] Objective To investigate and analyze the efficacy of low-dose Decitabine combined with Arubicin + Cytarabine + Recombinant Granulocyte Colony Stimulating Factor （CAG） regimen in the treatment of myelodysplastic syndrome. Methods From October 2011 to October 2018， 82 patients with myelodysplastic syndrome admitted to our hospital were selected as study subjects. They were divided into the study group （n=41） and the reference group （n=41） by the random number table method. Patients in the reference group were given conventional CAG， patients in the study group were treated with low-dose Decitabine combined CAG regimen. The clinical treatment effect of the two groups of patients was compared， and the adverse reactions of the two groups after treatment were observed. Results The remission rate of the patients in the study group was 78.05%， which was higher than that in the control group （58.54%）， the difference was statistically significant （P<0.05）. There was no significant difference in the total incidence rate of adverse reaction between the two groups （P>0.05）. Conclusion The treatment of patients with myelodysplastic syndrome with low-dose Decitabine combined with CAG is helpful to improve the clinical remission rate， and will not increase the obvious adverse reactions， and the safety is good.

[Key words] Myelodysplastic syndrome; Pre-excitation chemotherapy; Decitabine; Adverse reaction

骨髓增生異常综合征（MDS）是源于造血干细胞的异质性髓系克隆性疾病，患者会出现血细胞病态造血，病情严重的中高危患者可能会演变为急性髓系白血病（AML）[1-2]。两者的自然病程相似，均是起病迅速，进展较快，患者的预后不良，病死率高，是临床治疗的难点和重点。本病传统化疗的疗效一般，毒副反应重[3]。由阿柔比星、阿糖胞苷、重组粒细胞集落刺激因子构成的阿柔比星+阿糖胞苷+重组粒细胞集落刺激因子（CAG）预激化疗方案的毒副反应显著降低，是目前临床治疗MDS、AML的常用方案，但是化疗的缓解率不够理想[4]。脱氧核糖核酸（DNA）甲基化异常被认为是驱动肿瘤的影响因素。……