CAJ | 학술논문

[目的]观察乌苯美司片联合改良FLAG方案治疗难治性急性髓系白血病（AML）的临床疗效、不良反应及对免疫功能的影响。[方法]将30例难治性A M L患者分为治疗组与对照组各15例，两组患者均给予改良FLAG方案（由氟达拉滨、阿糖胞苷与粒细胞集落刺激因子组成）化疗，治疗组在治疗开始时给予乌苯美司30 mg 每日清晨顿服或每次10 mg ，3次/日，连用8周。比较两组患者治疗后的疗效。[结果]治疗组完全缓解率（C R ）为60％，明显高于对照组（40％），差异有显著性（ P ＜0．05）；治疗组总有效率（O R ）为73．3％；高于对照组的60％，但差异无显著性（ P ＞0．05）。治疗组粒细胞缺乏发生率、发热持续时间及粒细胞缺乏持续时间均低于对照组，且差异均有显著性（ P ＜0．05）。治疗组 T 淋巴细胞（CD3＋），T 辅助、诱导淋巴细胞（CD3＋、CD4＋），NK细胞（CD16＋、CD56＋）水平较用药前有所提高，而对照组均较化疗前下降，两组相比较差异有显著性（ P ＜0．05）。[结论]乌苯美司片能提高化疗药物对难治性AML的疗效，提高患者免疫功能，减轻化疗不良反应，改善化疗患者的生活质量。
[목적]관찰오분미사편연합개량FLAG방안치료난치성급성수계백혈병（AML）적림상료효、불량반응급대면역공능적영향。[방법]장30례난치성A M L환자분위치료조여대조조각15례，량조환자균급여개량FLAG방안（유불체랍빈、아당포감여립세포집락자격인자조성）화료，치료조재치료개시시급여오분미사30 mg 매일청신돈복혹매차10 mg ，3차/일，련용8주。비교량조환자치료후적료효。[결과]치료조완전완해솔（C R ）위60％，명현고우대조조（40％），차이유현저성（ P ＜0．05）；치료조총유효솔（O R ）위73．3％；고우대조조적60％，단차이무현저성（ P ＞0．05）。치료조립세포결핍발생솔、발열지속시간급립세포결핍지속시간균저우대조조，차차이균유현저성（ P ＜0．05）。치료조 T 림파세포（CD3＋），T 보조、유도림파세포（CD3＋、CD4＋），NK세포（CD16＋、CD56＋）수평교용약전유소제고，이대조조균교화료전하강，량조상비교차이유현저성（ P ＜0．05）。[결론]오분미사편능제고화료약물대난치성AML적료효，제고환자면역공능，감경화료불량반응，개선화료환자적생활질량。
[Objective]To observe the clinical efficacy and side effects of ubenimex tablets combined with the modified FLAG regimen for the treatment of refractory acute myeloid leukemia (AML) and its impact on immune function .[Methods] Thirty patients with refractory AML were divided into two groups with 15 pa-tients in each group .All patients were given the chemotherapy with the modified FLAG regimen (fludarabine+arabinosylcytosin+ granulocyte colony stimulating factor ) .At the beginning of the therapy ,the treatment group was given ubenimex tablets 30mg in the morning per day or 10mg per time ,3 times a day for 8 weeks . The efficacy after treatment was compared between two groups .[Results]The complete remission(CR) rate of treatment group was 60% ,which was obviously higher than that of control group (40% ) ,and there was sig-nificant difference in CR between two groups( P < 0 .05) .The total response rate(OR) of treatment group was 73 .3% ,which was higher than that of control group(60% ) ,but there was no significant difference( P>0 .05) .The incidence of neutropenia and the duration of fever and neutropenia in treatment group were lower than those in control group ,and there was significant difference( P <0 .05) .Compared with before medica-tion ,T-lymphocytes(CD3+ ) ,T-assisted and induced lymphocytes (CD3+ and CD4+ ) and NK cells (CD16+and CD56+ ) in treatment group were increased ,while those in control group were decreased ,and there was significant difference between two groups( P<0 .05) .[Conclusion]Ubenimex tablets can increase the efficacy of chemotherapy for refractory AML ,enhance the immune functions ,reduce chemotherapy-related side effects and improve quality of life of patients .