本文關(guān)鍵詞：去甲氧柔紅霉素聯(lián)合阿糖胞苷治療急性髓細(xì)胞白血病療效的系統(tǒng)評(píng)價(jià)　出處：《新疆醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 去甲氧柔紅霉素 柔紅霉素 阿糖胞苷 系統(tǒng)評(píng)價(jià) 隨機(jī)對(duì)照試驗(yàn)

【摘要】：目的：系統(tǒng)評(píng)價(jià)去甲氧柔紅霉素(IDA)與柔紅霉素(DNR)分別聯(lián)合阿糖胞苷(Ara-C)對(duì)急性髓細(xì)胞白血病的誘導(dǎo)緩解療效及安全性。方法：計(jì)算機(jī)檢索PubMed(1966-2014)、MEDLINE(1990-2014)、CBM(1978-2014)、CNKI(1979-2014)、 Wanfang Data(1998-2014)、VIP(1991-2014)等數(shù)據(jù)庫(kù),收集IDA與DNR分別聯(lián)合Ara-c治療急性髓細(xì)胞白血病的隨機(jī)對(duì)照試驗(yàn)(RCT),并追溯納入研究的參考文獻(xiàn).有兩位研究者按照納入與排除標(biāo)準(zhǔn)獨(dú)立篩選文獻(xiàn)、提取資料和評(píng)價(jià)質(zhì)量后,采取RevMan5.2軟件進(jìn)行系統(tǒng)評(píng)價(jià)分析。結(jié)果：共納入13個(gè)RCT,4347例患者.系統(tǒng)評(píng)價(jià)分析結(jié)果顯示：在治療急性髓細(xì)胞白血病的總有效率[RR=1.18,95%CI(1.06,1.32),P=0.003]、顯效率[RR=1.16,95%CI(1.07,1.27),h=0.0004]、復(fù)發(fā)率[RR=0.57,95%CI(0.34,0.94),P=0.03]方面去甲氧柔紅霉組均優(yōu)于柔紅霉素組,血液學(xué)不良反應(yīng)(1).骨髓幼稚細(xì)胞下降幅度[MD=13.02,95%CI(9.81,16.23),P0.00001]、(2).白細(xì)胞最低值[MD=-0.22,95%CI(-038,-0.07),P=0.004]、(3)兩組白細(xì)胞達(dá)到最低水平時(shí)間方面[MD=-2.26,95%CI(-3.13,-1.40),P0.00001],去甲氧柔紅霉素組對(duì)骨髓抑制更明顯,在兩組非血液學(xué)不良反應(yīng)方面,兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：現(xiàn)有證據(jù)顯示,去甲氧柔紅霉素聯(lián)合阿糖胞苷組(IA)在治療急性髓系白血病的有效率、緩解率、復(fù)發(fā)率方面優(yōu)于柔紅霉素聯(lián)合阿糖胞苷組(DA)。并且發(fā)生藥物不良反應(yīng)較低,安全性相對(duì)較高,同時(shí)在患者預(yù)后方面也優(yōu)于DA組。
[Abstract]:Objective: to evaluate the combination of normodaunorubicin (IDA) and daunorubicin (DNR) with cytarabine cytosine Ara-Crespectively. Methods: the efficacy and safety of induction and remission in acute myeloid leukemia were studied by computer search of PubMedus (1966-2014). MEDLINE (1990-2014 / CBM / 1978-2014 / CNKI 1979-2014). Wanfang data (1998-2014) and other databases. A randomized controlled trial of IDA and DNR combined with Ara-c in the treatment of acute myeloid leukemia was collected. According to the inclusion and exclusion criteria, two researchers independently screened the literature, extracted the data and evaluated the quality. Results: a total of 4347 patients with acute myeloid leukemia were included in this study. The results showed that the total effective rate in the treatment of acute myeloid leukemia was higher than that of the control group. [RRN 1.18 / 95 CIQ 1.06 / 1.32 / P0. 003]. [RRN 1.1695% CI1. 07 1. 27% 0.0004, recurrence rate 0. 0004. [The RRX 0.57 ~ 95CII 0.34 ~ 0.94% P0. 03 were better than the daunorubicin group. Hematological adverse reactions: decline of immature cells in bone marrow. [MDR 13.02 ~ 95CIQ 9.81 ~ 16.23% P0.00001] Leukocyte minimum value. [MDN-0.22% 95% CIQ -038U -0.07% P0. 004]) time of reaching the lowest level of white blood cells in the two groups. [MD-2.26 ~ 95% CI-3.13 + -1.40% (P0.00001), normodaunorubicin group had more obvious bone marrow suppression, in both groups non-hematological side effects. Conclusion: there is no significant difference between the two groups in the treatment of acute myeloid leukemia. Conclusion: the available evidence shows that normodaunorubicin combined with cytosine arabinoside group is effective and effective in the treatment of acute myeloid leukemia. The recurrence rate was better than that of daunorubicin combined with cytarabine group, and the adverse drug reaction was lower, the safety was higher, and the prognosis of the patients was better than that of DA group.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R733.71
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本文編號(hào)：1392952