中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
9期
964-966
,共3页
李莹%高松%化范例%邬扬炯
李瑩%高鬆%化範例%鄔颺炯
리형%고송%화범례%오양형
甲氨蝶呤%急性淋巴细胞性白血病%临床效果
甲氨蝶呤%急性淋巴細胞性白血病%臨床效果
갑안접령%급성림파세포성백혈병%림상효과
Methotrexate%Acute lymphoblastic leukemia%Clinical curative effect
目的 观察大剂量甲氨蝶呤治疗急性淋巴细胞白血病(ALL)的临床效果和不良反应.方法 来源于我院血液科ALL患者92例,随机分为观察组和对照组各46例.观察组应用大剂量甲氨蝶呤+长春新碱+环磷酰胺+吡柔比星化疗方案治疗;对照组予柔红霉素+长春新碱+泼尼松+左旋门冬酰胺酶治疗方案.比较两组的临床疗效、病情缓解所需疗程及不良反应发生情况.结果 观察组总有效率为84.78％ (39/46),对照组为80.43％ (37/46),两组差异无统计学意义(x2=0.45,P＞0.05).观察组病情缓解需(1.26±0.28)疗程,对照组为(1.31±0.31)疗程,两组差异无统计学意义(t=2.13,P＞0.05).观察组初治完全缓解率为75.00％ (24/32)、复治为50.00％(4/8)、难治为33.33％ (2/6);对照组分别为76.67％(23/30)、50.00％(4/8)、25.00％(2/8),两组差异无统计学意义(x2 =0.98,P＞0.05).观察组患者骨髓抑制发生率(23.91％)明显低于对照组(43.48％),而肝肾功能损伤发生率(54.35％)明显高于对照组(17.39％),差异有统计学意义(P均＜ 0.05).观察组患者5年生存率为67.39％,对照组为45.65％,两组比较差异有统计学意义(P＜0.05).结论 大剂量甲氨蝶呤用于治疗ALL临床效果确切,不良反应尚可耐受.
目的 觀察大劑量甲氨蝶呤治療急性淋巴細胞白血病(ALL)的臨床效果和不良反應.方法 來源于我院血液科ALL患者92例,隨機分為觀察組和對照組各46例.觀察組應用大劑量甲氨蝶呤+長春新堿+環燐酰胺+吡柔比星化療方案治療;對照組予柔紅黴素+長春新堿+潑尼鬆+左鏇門鼕酰胺酶治療方案.比較兩組的臨床療效、病情緩解所需療程及不良反應髮生情況.結果 觀察組總有效率為84.78％ (39/46),對照組為80.43％ (37/46),兩組差異無統計學意義(x2=0.45,P＞0.05).觀察組病情緩解需(1.26±0.28)療程,對照組為(1.31±0.31)療程,兩組差異無統計學意義(t=2.13,P＞0.05).觀察組初治完全緩解率為75.00％ (24/32)、複治為50.00％(4/8)、難治為33.33％ (2/6);對照組分彆為76.67％(23/30)、50.00％(4/8)、25.00％(2/8),兩組差異無統計學意義(x2 =0.98,P＞0.05).觀察組患者骨髓抑製髮生率(23.91％)明顯低于對照組(43.48％),而肝腎功能損傷髮生率(54.35％)明顯高于對照組(17.39％),差異有統計學意義(P均＜ 0.05).觀察組患者5年生存率為67.39％,對照組為45.65％,兩組比較差異有統計學意義(P＜0.05).結論 大劑量甲氨蝶呤用于治療ALL臨床效果確切,不良反應尚可耐受.
목적 관찰대제량갑안접령치료급성림파세포백혈병(ALL)적림상효과화불량반응.방법 래원우아원혈액과ALL환자92례,수궤분위관찰조화대조조각46례.관찰조응용대제량갑안접령+장춘신감+배린선알+필유비성화료방안치료;대조조여유홍매소+장춘신감+발니송+좌선문동선알매치료방안.비교량조적림상료효、병정완해소수료정급불량반응발생정황.결과 관찰조총유효솔위84.78％ (39/46),대조조위80.43％ (37/46),량조차이무통계학의의(x2=0.45,P＞0.05).관찰조병정완해수(1.26±0.28)료정,대조조위(1.31±0.31)료정,량조차이무통계학의의(t=2.13,P＞0.05).관찰조초치완전완해솔위75.00％ (24/32)、복치위50.00％(4/8)、난치위33.33％ (2/6);대조조분별위76.67％(23/30)、50.00％(4/8)、25.00％(2/8),량조차이무통계학의의(x2 =0.98,P＞0.05).관찰조환자골수억제발생솔(23.91％)명현저우대조조(43.48％),이간신공능손상발생솔(54.35％)명현고우대조조(17.39％),차이유통계학의의(P균＜ 0.05).관찰조환자5년생존솔위67.39％,대조조위45.65％,량조비교차이유통계학의의(P＜0.05).결론 대제량갑안접령용우치료ALL림상효과학절,불량반응상가내수.
Objective To analyze the clinical efficacy,adverse events and corresponding preventive measures of high dose methotrexate in the treatment of acute lymphoblastic leukemia(ALL).Methods Ninety-two patients with ALL who hospitalized in Heamotology Department of Jinshan Hospital Affiliated to Fudan University were randomly divided into observation group and control group,and each group had 46 cases.Patients in observation group were given high dose melhotrexate + vincristine + cytoxan + pirarubicin chemotherapy treatment,and in control group were given soft red enzyme + vincristine + metacortan dracin + L-asparaginase treatment.The clinical efficacy,adverse events and the required course of remission of two groups were compared.Results The total effective rate in the observation group was 84.78％,while it was 80.43％ in the control group,and there was no statistically significant difference (x2 =0.45,P ＞ 0.05).The average remission was (1.26 ± 0.28) in the observation group,while (1.31 ± 0.31) in the control group,and no significant difference was observed (t =2.13,P ＞ 0.05).The complete remission rate of initial treatment,retreatment and refractory were 75.00％ (24/32),50.00％ (4/8) and 33.33％ (2/6) respectively in observation group,while 76.67％ (23/30),50.00％ (4/8) and 25.00％ (2/8) respectively in control group,and there was no statislically significant difference between two groups (x2 =0.98,P ＞0.05).The rate of bone marrow suppression in the observation group(23.91％) was lower than that in the control group(43.48％),while the rate of liver and kidney injury(54.35％) was higher than that inthe control group(17.39％),which showed significant difference (P ＜ 0.05).The survival rate of 5 years in observation group was 67.39％,while 45.65％ in control group,and there was statistically significant difference between two groups (P ＜ 0.05).Conclusion The high dose methotrexate in the treatment of acute lymphoblastic leukemia was proved to be effective and the adverse reactions could be tolerated.
