贵州医科大学学报

2020, v.45;No.243(12) 1469-1473

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地西他滨联合CAG化疗方案对AML老年患者IGF-1和VEGF水平及免疫功能的影响
Effects of Decitabine Combined With CAG Chemotherapy Regimen on IGF-1,VEGF Levels,and Immune Function of Elderly Patients with AML

雷丽华;张开基;任丽蓉;任倩;费晓莉;侯铮;林娟;
LEI Lihua;ZHAGN Kaiji;REN Lirong;REN Qian;FEI Xiaoli;HOU Zheng;LIN Juan;Department of Hematology,the First People's Hospital;

摘要(Abstract):

目的:分析地西他滨联合CAG化疗方案对急性髓细胞性白血病(AML)老年患者胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)水平及免疫功能的影响。方法:选取血液科收治的AML老年患者120例,随机均分为对照组(CAG化疗方案)和观察组(地西他滨联合CAG化疗方案),分别抽取2组患者治疗前和治疗14 d时的空腹清晨静脉血5 m L,采用流式细胞仪检测全血CD3~+、CD4~+及CD8~+,并计算CD4~+/CD8~+比值;采用酶联免疫吸附法检测血清IGF-1和VEGF水平,比较2组患者治疗14 d时血液学、肝肾功能、胃肠道及感染发生情况和治疗疗效。结果:治疗14 d时,2组患者全血CD3~+、CD4~+、CD4~+/CD8~+I及IGF-1均较治疗前升高、且观察组高于对照组(P <0. 05),血清VEGF均较治疗前较低、且观察组低于对照组(P <0. 05);观察组患者治疗后血液学不良反应、肝肾功能、胃肠道不良反应及感染发生率与对照组比较差异均无统计学意义(P>0. 05);观察组患者治疗后总有效率高于对照组(P <0. 05)。结论:地西他滨联合CAG化疗方案可更好地降低AML老年患者血清VEGF水平,升高血清IGF-1水平,抑制疾病进展,改善患者免疫功能,同时不会增加用药后的不良反应。
Objective: To examine the effects of decitabine combined with CAG chemotherapy regimen on the levels of insulin-like growth factor-1( IGF-1),vascular endothelial growth factor( VEGF) and immune function in elderly patients with acute myeloid leukemia( AML). Methods: A total of 120 elderly AML patients admitted to the Department of Hematology were selected and randomly divided into control group( CAG chemotherapy regimen) and observation group( decitabine combined with CAG chemotherapy regimen). Five m L of fasting early morning venous blood/each patient was collected before the treatment and on 14 thday of the treatment. Flow cytometry was used to detect CD3~+,CD4~+,and CD8~+in whole blood. The ratio of CD4~+/CD8~+was calculated. Serum IGF-1 and VEGF levels were detected by enzyme-linked immunosorbent assay. Hematology,liver and kidney function,gastrointestinal tract and infection occurrence and treatment efficacy were compared between two groups on 14 th day of the treatment. Results: Whole blood CD3~+,CD4~+,CD4~+/CD8~+,and IGF-1 were greater on the 14 thday of treatment than those before treatment,and higher in observation group than those in control group( P < 0. 05). In contrast,the treatment increased the serum level of VEGF,which was lower in observation group than in control group( P < 0. 05). There was no statistical difference in the incidence of hematological adverse reactions,liver and kidney function,gastrointestinal adverse reactions and infection rates between the two groups( P > 0. 05).Treatment efficacy was higher in observation group than that in control group( P < 0. 05).Conclusion: Decitabine combined with CAG chemotherapy can decrease serum VEGF level in elderly AML patients,increase the serum IGF-1 level,inhibit AML progression,improve the patient's immune function,but not lead to the adverse reactions.

关键词(KeyWords): T淋巴细胞;血管内皮生长因子类;胰岛素样生长因子Ⅰ;急性髓细胞性白血病;地西他滨;CAG化疗方案;免疫功能
T-lymphocytes;vascular endothelial growth factors(VEGF);insulin-like growth factor 1(IGF-1);acute myeloid leukemia(AML);decitabine;CAG chemotherapy regimen;immune function

Abstract:

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基金项目(Foundation): 四川省医学科研课题计划(S18063)

作者(Author): 雷丽华;张开基;任丽蓉;任倩;费晓莉;侯铮;林娟;
LEI Lihua;ZHAGN Kaiji;REN Lirong;REN Qian;FEI Xiaoli;HOU Zheng;LIN Juan;Department of Hematology,the First People's Hospital;

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DOI: 10.19367/j.cnki.2096-8388.2020.12.020

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