CAJ | 학술논문

目的探讨全反式维甲酸(ATRA)联合亚砷酸(As2O3)诱导治疗急性早幼粒细胞白血病(APL)凝血及纤溶指标的变化.方法治疗组18例,采用ATRA 20-30 mg/d,分3次口服,直至完全缓解.0.1%As2O310 ml加入5%葡萄糖注射液500ml静脉滴注,1次/d,连续28d.对照组10例,单用ATRA 45～60 mg/d,分3次口服.直至完伞缓解.结果治疗组CR17例,对照组CR8例,治疗组CR率高于对照组(P＜0.05);对照组出现不同程度的口干、维甲酸综合征等,有2例被迫停药,治疗组上述反应轻,出现肝功能损害,需加强保肝治疗;治疗组纤维蛋白原含量(Fbg)、D-二聚体(D-dimer)恢复时间分别为7、21d.对照组Fbg、D-dimer恢复时间分别为14、28d.结论 ATRA联合As2O3诱导治疗APL CR率高,副作用小,凝血、纤溶指标恢复快,D-dimer作为早期诊断及观察治疗变化意义重大.
목적 탐토전반식유갑산(ATRA)연합아신산(As2O3)유도치료급성조유립세포백혈병(APL)응혈급섬용지표적변화.방법 치료조18례,채용ATRA 20-30 mg/d,분3차구복,직지완전완해.0.1%As2O310 ml가입5%포도당주사액500ml정맥적주,1차/d,련속28d.대조조10례,단용ATRA 45～60 mg/d,분3차구복.직지완산완해.결과 치료조CR17례,대조조CR8례,치료조CR솔고우대조조(P＜0.05);대조조출현불동정도적구간、유갑산종합정등,유2례피박정약,치료조상술반응경,출현간공능손해,수가강보간치료;치료조섬유단백원함량(Fbg)、D-이취체(D-dimer)회복시간분별위7、21d.대조조Fbg、D-dimer회복시간분별위14、28d.결론 ATRA연합As2O3유도치료APL CR솔고,부작용소,응혈、섬용지표회복쾌,D-dimer작위조기진단급관찰치료변화의의중대.
Objective To explore the indexes change of coagulation and fibrinolysis in APL with ATRA and As2O3.Methods Treatment group 18 eases were undeaaked ATRA 20-30 mg/d until relieved completely.0.1%arsenic trioxide 10 ml with 5%glucose 500 ml for 28 days.Normal control 10 cases were undertaked ATRA 45～60 mg/d until relieved completely.Results The CR rate of treatment group was higher than control group(P＜0.05),the patients of control group showed different reactions such as thirsty mouth,rationale acid syndrome.2 cases reacted strongly and the treatment had to be interrupted,the patients of treatment group had little reaction,but liver function were badly hurt and liver-protection treatment was needed.Fbg,D-dimer recovery time is 7 days,21 days in treatment group,14 days,21 days in control group.Conclusion CR rate is high and has little side effect,and indexes change of coagulation and fibrinolysis were recovered quickly,it has great significance to take D-dimer as early diagnose and observe the indexes change during the treatment.