CAJ | 학술논문

目的：分析不同剂量地西他滨对骨髓增生异常综合征（myelodysplastic syndrome，MDS）患者的安全性及临床治疗效果。方法选取本院2012年4月至2014年6月78例明确诊断为MDS患者为研究对象，采用随机数表法分为A、B、C三组，均给予地西他滨治疗，A组患者给药剂量为15 mg/（m2?d），静脉滴注＞1小时，每周5天；B组为20 mg/（m2?d），静脉滴注＞1小时，每周5天；C组为25 mg/（m2?d），静脉滴注＞1小时，每周5天；三组患者均连续治疗3个月。比较治疗前后三组患者血管内皮细胞生长因子（VEGF）水平、临床疗效及不良反应发生情况。结果治疗后B组患者VEGF水平低于A、C组（P＜0.05）。A组显效8例，有效7例，总有效率为57.69%；B组显效10例，有效13例，总有效率为88.46%，C组显效9例，有效12例，总有效率为80.77%，三组比较差异显著（P＜005）， A组与B、C组比较差异显著（P＜0.05），B、C组比较无显著差异（P＞0.05）。三组患者治疗期间不良反应发生率比较无显著差异（P＞0.05）。结论地西他滨能够有效治疗MDS，剂量为20 mg/（m2?d）其安全性和临床效果最佳。
목적：분석불동제량지서타빈대골수증생이상종합정（myelodysplastic syndrome，MDS）환자적안전성급림상치료효과。방법선취본원2012년4월지2014년6월78례명학진단위MDS환자위연구대상，채용수궤수표법분위A、B、C삼조，균급여지서타빈치료，A조환자급약제량위15 mg/（m2?d），정맥적주＞1소시，매주5천；B조위20 mg/（m2?d），정맥적주＞1소시，매주5천；C조위25 mg/（m2?d），정맥적주＞1소시，매주5천；삼조환자균련속치료3개월。비교치료전후삼조환자혈관내피세포생장인자（VEGF）수평、림상료효급불량반응발생정황。결과치료후B조환자VEGF수평저우A、C조（P＜0.05）。A조현효8례，유효7례，총유효솔위57.69%；B조현효10례，유효13례，총유효솔위88.46%，C조현효9례，유효12례，총유효솔위80.77%，삼조비교차이현저（P＜005）， A조여B、C조비교차이현저（P＜0.05），B、C조비교무현저차이（P＞0.05）。삼조환자치료기간불량반응발생솔비교무현저차이（P＞0.05）。결론지서타빈능구유효치료MDS，제량위20 mg/（m2?d）기안전성화림상효과최가。
ObjectiveTo analyze the safety and clinical effect of different doses of decitabine in the treatment of myelodysplastic syndrome (MDS).Method78 patients with MDS in our hospital from April 2012 to June 2014 were selected as objects of study, they were divided into A, B, C three groups by a random number table, and all were treated with decitabine, patients in group A adopted dose 15 mg/(m2?d), intravenous infusion> 1 hour, 5 days a week; group B was 20 mg /(m2?d), intravenous infusion> 1 hour, 5 days a week; group C was 25 mg /(m2?d), intravenous infusion> 1 hour, 5 days a week; the three groups of patients were treated for 3 months consecutivly. Vascular endothelial growth factor (VEGF) levels, efficacy and adverse reactions before and after the treatment were compared.ResultVEGF level after treatment of patients in group B was lower than group A and group C (P<0.05). In group A, 8 cases were markedly effective, 7 cases effective, the total effective rate was 57.69%; in group B, 10 cases were markedly effective, 13 cases effective, the total effective rate was 88.46%, in group C, 9 cases were markedly effective, 12 cases effective, the total effective rate was 80.77%, the differences between the three groups were signiifcant (P<0.05), the differences between group A and B, group C were signiifcant (P<0.05), the differences between group B and group C were not significant (P>0.05); the differences of the incidence of adverse reactions during the treatment between the three groups of patients were not signiifcant (P>0.05).ConclusionDecitabine can effectively treat MDS, a dose of 20 mg / (m2?d) has the best safety and clinical effect.