阿扎胞苷联合全反式维 A 酸对中高危 骨髓增生异常综合征患者的疗效

The Efficacy of Azacytidine Combined with All Trans Retinoic Acid in Patients with Medium to High Risk Myelodysplastic Syndrome

摘要:

〔摘 要〕 目的：探究阿扎胞苷联合全反式维 A 酸（ATRA）治疗中高危骨髓增生异常综合征（MDS）的临床效果。 方法：回顾性分析江门市中心医院 2016 年 2 月至 2019 年 12 月收治的 33 例中高危 MDS 患者作为对照组，应用成分输血、 促造血及一般对症支持治疗，将 2020 年 1 月至 2023 年 1 月江门市中心医院收治的中高危 MDS 患者 33 例作为观察组，在 对照组基础上应用阿扎胞苷联合 ATRA 治疗。比较两组患者治疗前后的血红蛋白（Hb）、血小板计数（PLT）和中性粒细 胞计数（ANC）以及两组患者的输血间隔、输血量、临床疗效及不良反应。 结果：治疗后，观察组患者 Hb、PLT 和 ANC 水平均高于对照组，输血间隔大于对照组，输血量少于对照组，完全缓解率和总反应率高于对照组，差异均具有统计学意义 （P ＜ 0.05）。治疗期间，两组患者的胃肠道反应发生率比较，差异无统计学意义（P ＞ 0.05），观察组患者的发热及感染、 出血发生率低于对照组，差异均具有统计学意义（P ＜ 0.05）。 结论：阿扎胞苷联合 ATRA 治疗中高危 MDS 有较好的疗效， 可以改善患者的临床症状，延长患者输血间隔，降低患者输血量，且安全性较高。

Abstract:

〔Abstract〕 Objective To investigate the clinical efficacy of azacytidine combined with all trans retinoic acid (ATRA) in the treatment of medium to high-risk myelodysplastic syndrome (MDS). Methods A retrospective analysis was conducted on 33 patients with medium to high risk MDS admitted to Jiangmen Central Hospital from February 2016 to December 2019 as a control group, who were treated with component blood transfusion, hematopoiesis promotion, and general symptomatic support, and 33 patients with medium to high risk MDS admitted to Jiangmen Central Hospital from January 2020 to January 2023 as an observation group, who were treated with azacitidine combined with ATRA on the basis of the control group. The hemoglobin (Hb), platelet count (PLT), and neutrophil count (ANC) of two groups of patients before and after treatment, as well as the blood transfusion interval, transfusion volume, clinical efficacy, and adverse reactions of the two groups of patients were compared. Results After treatment, the levels of Hb, PLT, and ANC in the observation group were higher than those in the control group, the blood transfusion interval was greater than that in the control group, the blood transfusion volume was less than that in the control group, and the complete remission rate and total response rate were higher than those in the control group, the differences were statistically significant (P < 0.05). During the treatment period, there was no statistically significant difference in the incidence of gastrointestinal reactions between the two groups, the difference was not statistically significant (P > 0.05). The incidence of fever, infection, and bleeding in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). Conclusion The combination of azacytidine and ATRA has good efficacy in the treatment of high-risk MDS, which can improve clinical symptoms, prolong blood transfusion intervals, reduce blood transfusion volume, and have high safety.