地西他滨联合小剂量HAG方案对急性髓系白血病患者细胞免疫功能及血清COX-2、bFGF的影响

目的:探讨地西他滨联合小剂量高三尖杉酯碱⁺阿糖胞苷⁺重组人粒细胞集落刺激因子(HAG)方案对急性髓系白血病(AML)患者细胞免疫功能及血清环氧合酶-2(COX-2)、碱性成纤维细胞生长因子(bFGF)的影响。方法:选取2016年4月~2019年4月期间山西白求恩医院收治的AML患者93例,根据随机数字表法分为对照组(n=46,HAG方案)和研究组(n=47,地西他滨联合小剂量HAG方案),比较两组患者临床疗效、细胞免疫功能、血清COX-2、bFGF水平的变化情况,记录两组治疗期间不良反应情况。结果:研究组治疗后的临床总有效率为80.85%(38/47),高于对照组的56.52%(26/46)(P<0.05)。两组治疗后CD3⁺、CD4⁺/CD8⁺、CD4⁺水平均下降,但研究组高于对照组(P<0.05);两组患者CD8⁺水平均升高,且研究组高于对照组(P<0.05)。两组治疗后血清COX-2、bFGF水平均下降,且研究组低于对照组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:地西他滨联合小剂量HAG方案治疗可减轻AML患者机体免疫抑制,改善血清COX-2、bFGF水平,且用药安全性较好。

The Effect of Decitabine Combined with Low Dose HAG Scheme on the Cellular Immune Function and Serum COX-2 and bFGF in Patients with Acute Myeloid Leukemia

ABSTRACT Objective: To investigate the effects of decitabine combined with low dose homoharringtonine and cytarabine and recombinant human granulocyte colony stimulating factor (HAG) scheme on the cellular immune function, serum cyclooxygenase-2 (COX-2) and basic fibroblast growth factor (bFGF) in patients with acute myeloid leukemia (AML). Methods: 93 patients with AML in Shanxi Bethune hospital from April 2016 to April 2019 were selected, they were divided into control group (n=46, HAG scheme) and study group (n=47, decitabine combined with low dose HAG scheme) according to the method of random number table. The changes of clinical efficacy, cellular immunity, serum COX-2, bFGF levels of the two groups were compared, and adverse reactions during treatment were recorded in the two groups. Results: The total clinical effective rate of the study group was 80.85% (38/47), which was higher than 56.52% (26/46) of the control group (P<0.05). After treatment, the levels of CD3⁺, CD4⁺/CD8⁺, and CD4⁺ in the two groups decreased, but those in the study group were higher than those in the control group (P<0.05). The level of CD8⁺ in the two groups increased, and that in the study group was higher than that in the control group (P<0.05). After treatment, the levels of serum COX-2 and bFGF in the two groups decreased, and those in the study group were lower than those in the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The treatment of dexithabine combined with low dose HAG scheme can reduce the immunosuppression of AML patients, improve the levels of serum COX-2 and bFGF, and the drug safety is good.