李方枚

[摘要] 目的 分析高三尖杉酯碱联合阿糖胞苷治疗老年急性髓系白血病的临床效果。 方法 将本院收治的42例急性髓系白血病患者随机分为观察组21例和对照组21例，对照组采用柔红霉素+阿糖胞苷联合化疗，观察组采用高三尖杉酯碱+阿糖胞苷联合化疗，评价两组的临床疗效、不良反应发生率、3年内复发率、3年内累计生存率及中位生存时间。 结果 观察组的总有效率为85.71%，高于对照组的66.67%，差异有统计学意义（P＜0.05）。观察组的Ⅲ～Ⅳ级感染、Ⅲ～Ⅳ级出血、肝肾毒性发生率低于对照组，差异有统计学意义（P＜0.05）。观察组的3年内复发率低于对照组，3年内累计生存率高于对照组，中位生存时间长于对照组，差异有统计学意义（P＜0.05）。 结论 高三尖杉酯碱联合阿糖胞苷治疗老年急性髓系白血病能有效提高临床效果，降低药物毒副反应，并提高患者的远期疗效，值得临床推广应用。

[关键词] 急性髓系白血病；老年；高三尖杉酯碱；阿糖胞苷

[中图分类号] R557[文献标识码] A[文章编号] 1674-4721（2014）05（c）-0077-03

Effect of homoharringtonine combined with cytosine arabinoside in the treatment of elderly acute myeloid leukemia

LI Fang-mei

Department of Hematology,People′s Hospital of Dexing City in Jiangxi Province,Dexing 334200,China

[Abstract] Objective To analyze the clinical effects of homoharringtonine combined with cytosine arabinoside in the treatment of elderly acute myeloid leukemia(AML). Methods Forty-two patients with AML admitted into our hospital were randomly divided into observation group and control group.Combined chemotherapy of daunoblastina and cytosine arabinoside were used in control group,combined chemotherapy of homoharringtonine and cytosine arabinoside were used in observation group.The clinical curative effect,incidence rate of adverse reaction,recurrence rate within 3 years,cumulative survival rate within 3 years and median survival time in two groups was calculated respectively. Results Total effective rate in observation group was 85.71%,higher than that in control group(66.67%),with statistical difference(P＜0.05).The incidence rate of degree Ⅲ-Ⅳ infection,Ⅲ-Ⅳ hemorrhage,liver and kidney toxicity in observation group was lower than that in control group respectively,with statistical difference(P＜0.05).The recurrence rate within 3 years in observation group was lower than that in control group,cumulative survival rate within 3 years in observation group was higher than that in control group,median survival time in observation group was longer than that in control group,with statistical difference(P＜0.05). Conclusion Homoharringtonine combined with cytosine arabinoside in the treatment of elderly AML can effectively improve the clinical therapeutic effect and long-term effect,decrease the incidence rate of drug toxicity,which is worthy of expansion and application in clinic.

[Key words] Acute myeloid leukemia;Elderly;Homoharringtonine;Cytosine arabinosid

急性髓系白血病（acute myeloid leukemia，AML）是发生于骨髓、外周血或其他组织中的髓系原始细胞克隆性增殖性疾病。近年来，随着工业化程度越来越高及环境污染的恶化，全球白血病的发病率也越来越高。临床上，血液恶性疾病尤其是白血病等血液恶性肿瘤的治疗，时常采用化疗甚至是大剂量化疗，但老年AML患者因脏器功能衰退，机体抵抗力较差，在化疗期间易发生感染，出血及心、肺、肝、肾衰竭等并发症，对治疗的耐受性低，给患者治疗带来更大的风险[1]。……