李葳++林晓燕++王南京

DOI：10.16662/j.cnki.1674-0742.2017.23.129

[摘要] 目的 對比分析DA与MA方案治疗急性髓系白血病临床效果。 方法 方便选取从2010年3月—2014年5月在该院血液科就诊的68例AML患者，根据治疗需求分为两组，对照组采用DA诱导方案治疗，有36例患者；实验组采用MA诱导方案治疗，有32例患者。对比分析两组患者的临床治疗效果，不良反应及CR患者3年内疾病复发情况。结果 在对照组中有15例患者症状未缓解，15例患者完全缓解，CR缓解率为41.7%，有21例患者临床治疗有效，总有效率为66.7%；而在实验组中，有5例患者未缓解，22例患者完全缓解，CR缓解率为68.8%，总有效率为84.4%；实验组患者CR缓解率显著的高于对照组（χ2=3.832，P<0.05）；总有效率也显著的优于对照组（χ2=3.187，P<0.05）。且两组患者在肾毒性、肝毒性、心脏损害、出血、脱发、感染、呕吐恶心等不良反应上，差异无统计学意义（P>0.05）。对照组中位生存时间为1.3年，实验组的中位生存时间为1.9年；对照组中， CR患者3年复发患者12例，总发生率为80.0%；而实验组中，3年复发患者13例，总发生率为59.1%；两组之间差异有统计学意义（χ2=3.424，P<0.05）。结论 MA诱导方案治疗急性髓系白血病临床效果优于DA诱导方案，提高患者生存周期，降低CR疾病复发率，在临床中具有推广和应用的价值。

[关键词] 柔红霉素；米托蒽醌；阿糖胞苷；急性髓系白血病

[中图分类号] R733 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0129-04

Comparative Analysis of Clinical Effects of DA and MA Regimen in the Treatment of Acute Myeloid Leukemia

LI Wei， LIN Xiao-yan， WANG Nan-jing

Department of Hematology， Sanming No.1 Hospital Affiliated to Fujian Medical University， Sanming， Fujian Province， 365000 China

[Abstracts] Objective This paper tries to compare the clinical efficacy of DA and MA regimen in the treatment of acute myeloid leukemia. Methods 68 cases of AML patients treated in this hospital from March 2012 to May 2014 were convenient selected and divided into two groups according to the treatment needs， 36 patients in the control group adopted DA induction regimen for treatment； 32 patients in the experimental group adopted MA induction regimen for treatment. The clinical efficacy， side effects and recurrence of CR of the two groups in 3 years were analyzed. Results In the control group， 15 patients did not relieve symptoms， 15 patients completely relieved symptoms， CR remission rate was 41.7%， 21 patients were effective in clinical treatment， the total effective rate was 66.7%； in the experimental group， 5 patients did not relieve， 22 patients completely relieved， the CR remission rate was 68.8% and the total effective rate was 84.4%. The CR rate of the patients in the experimental group was significantly higher than that in the control group （χ2=3.832，P<0.05）， and the total effective rate was higher than the control group （χ2=3.187， P<0.05）. There was no significant difference between the two groups in adverse reactions such as nephrotoxicity， hepatotoxicity， heart damage， hemorrhage， alopecia， infection and vomiting and nausea（P>0.05）. The median survival time was 1.3 years in the control group and 1.9 years in the experimental group. In the control group， 12 patients with CR had recurrence in 3 years， the total incidence was 80.0%. In the experimental group， 13 cases had recurrence in 3 years， the total incidence was 59.1%； the difference between the two groups was significant （χ2=3.424， P<0.05）. Conclusion The MA induced regimen is more effective than DA induced regimen in the treatment of acute myeloid leukemia. It can improve the life cycle of patients and reduce the recurrence rate of CR， which is worth popularization and application in clinical practice.

[Key words] Daunorubicin； Mitoxantrone； Cytarabine； Acute myeloid leukemia

急性髓系白血病（AML）为血液系统恶性肿瘤，是由于髓系细胞恶性增殖引发的疾病，在临床中患者常常表现为贫血、出血以及发热等症状。AML具有着较高的致死率，在临床的治疗中常采用诱导化疗后进行强化、巩固治疗，因此化疗药物选择与应用对于AML的临床治疗具有着重要的意义[1-2]。……