目的 探讨不同剂量α-干扰素与奥扎格雷联合治疗原发性血小板增多症(ET)的效果与安全性.方法 选取2019年3月～2021年3月河北省邯郸市第一医院收治的40例ET患者为研究对象,按照随机数表法分为对照组(n=20)和观察组(n=20).两组患者入院后均行对症治疗,并给予奥扎格雷静脉滴注治疗.在此基础上,对照组予以5×106 U/次α-干扰素治疗,每周2～3次,观察组予以3×106 U/次α-干扰素治疗,每隔1 d用药1次.比较两组临床疗效、血小板计数、症状消失后持续时间、药效持续时间以及不良反应发生情况.结果 观察组治疗有效率为70.0％(14/20),略低于对照组治疗有效率80.0％(16/20),差异无统计学意义(P>0.05).治疗12个月后,观察组患者血小板计数低于对照组,差异有统计学意义(P<0.05).两组药效持续时间比较差异无统计学意义(P>0.05),但观察组患者症状消失后持续时间长于对照组,差异有统计学意义(P<0.05).观察组不良反应发生率为10.0％(2/20),低于对照组不良反应发生率40.0％(8/20),差异有统计学意义(P<0.05).结论 3×106 U/次,隔天给药的α-干扰素治疗可以在确保临床疗效的同时,降低患者不良反应发生情况,提高患者耐受性,更适用于长效治疗.

急性髓系白血病(Non-m3 acute myeloid leukemia,简称AML)属于恶性血液系统疾病之一,具有分子遗传学与细胞遗传学的异质性疾病.疾病在发病中,细胞遗传学改变是评定患者预后的重要依据,但是因为其分子水平上抑制性较高,故该疾病使用常规细胞遗传学技术的检测率较低.本综述主要就四种基因(FLT3、NPM1、DNMT3A及IDH)突变的特点和发病机制对于非M3型急性髓系白血病预后的影响效果展开[1].

Objective To observe the effect of low dose thalidomide ( LD-T ) in the maintenance treatment of multiple myeloma ( MM ) and it's influence of serum related indexes. Methods 90 patients with MM were randomly divided into the control group ( n=43, by adopt-ing the standardized dose of VAD scheme ) and the observation group ( n=47, combining with the LD-T maintenance therapy on the ba-sis of the control group ) . The effects and the changes of serum related indexes after 3 courses of treatment were compared between the two groups. Results The effective rate in the observation group was 85. 11%, which was significantly higher than 67. 44% in the con-trol group ( P<0. 05 ) . The decrease amplitude of serum M protein, VEGF and IL-6 levels, and plasma cells in bone marrow after treat-ment were significantly higher than that of the control group ( P<0. 05 );the elevation amplitude of hemoglobin after treatment was sig-nificantly higher than that in the control group ( P<0. 05 ) . The adverse reactions had no statistically significant difference between the two groups. Conclusion The LD-T maintenance treatment has significant efficacy and small toxic and side effects in the treatment of MM,which can significantly decrease the serum VEGF and IL-6 levels and is the preferred treatment regimen for MM.

目的 比较吡柔比星联合阿糖胞苷与柔红霉素联合阿耱胞苷治疗急性早幼粒细胞白血病疗效及不良反应.方法 选择医院收治的急性早幼粒细胞白血病患者92例,随机分为观察组与对照组,每组各46例.对照组给予柔红霉素联合阿糖胞苷进行治疗,观察组给予吡柔比星联合阿糖胞苷进行治疗.对两组患者治疗后的临床疗效、G-CSF次数、红细胞平均输注量、血小板平均输注量、血液指标及不良反应发生率进行比较.结果 ①观察组患者的总有效率与对照组相比较,差异无统计学意义(P＞0.05).②观察组患者的G-CSF使用次数明显高于对照组(P＜0.05);观察组患者的红细胞平均输注量及血小板平均输注量明显高于对照组(P＜0.05).③观察组患者治疗后的血液指标与对照组相比较,差异无统计学意义(P＞0.05).④观察组患者治疗后不良反应发生率与对照组相比较,差异无统计学意义(P＞0.05).结论 吡柔比星联合阿糖胞苷与柔红霉素联合阿糖胞苷治疗急性早幼粒细胞白血病的临床疗效与不良反应相当,但吡柔比星联合阿糖胞苷的心脏毒性较小,可作为急性早幼粒细胞白血病的一线治疗方法.

目的:观察血管内皮生长因子(VEGF)水平对成人过敏性紫癜肾炎(HSPN)的影响。方法:选择成人HSPN 32例为观察组,另选择健康成人32例为对照组,采用酶联免疫吸附法测定血清VEGF,比较两组血清VEGF水平。同时,根据观察组不同病情,测定并比较轻、中、重型患者血清VEGF水平。结果:观察组血清VEGF水平非常显著高于对照组(P<0.01);轻、中型患者血清VEGF水平非常显著高于重型患者和对照组(P<0.01);重型患者血清VEGF水平非常显著低于对照组(P<0.01)。结论:成人HSPN血清VEGF水平显著升高,可在一定程度上反映病情的轻重和预后。

目的 探讨内皮型一氧化氮合酶基因G894T多态性与成人过敏性紫癜易感性的关系.方法 将邯郸市第一医院治疗的98例成人过敏性紫癜患者作为观察组,同时随机选取同一时间进行体检的91例健康成人作为对照组.首先从两组所有人体内提取DNA,然后在PCR扩增仪上完成对内皮型一氧化氮合酶基因进行目的片段的扩增,接着进行酶切.最后观察酶切产物.结果 观察组患者体内G基因明显多于对照组的健康群体(P＜0.05).结论 机体内皮型一氧化氮合酶基因G894T增多会增加成人过敏性紫癜的发生,其易感性与内皮型一氧化氮合酶基因G894T多态性有很大的关系.

Objective To summarize the clinical features of adult patients with abdominal type Henoch Scholein Purpura(HSP) to improve the early diagnosis and therapeutic outcome of HSP.Methods The clinical features of 31 adult patients with abdominal type HSP from the Hematology department of Handan First Hospital between March 2007 to June 2010 were retrospectively reviewed and compared with that of 30 adult patients with non-abdominal type HSP.Results All the 31 patients had abdominal pain.Of those patients,48.4％ had periumbilical colicky pain, 38.7％ had whole abdominal pain and 12.9％ had lower abdominal pain.The other clinical manifestations included nausea/vomiting(19.4％) ,positive feces occult blood test(45.1％) .EGD and Colonoscopy of 13 patients showed mucosal congestion, red macda, erosion and ulceration mainly in the descending duodenum, distal ileum and rectosigmoid.There was no difference in age, gender, allergic history and predisposing infection between those with abdominal pain and without.The patients with abdominal pain had more cases of mixed-type HSP than those without and the difference was significant (P ＜ 0.01) .Conclusion Patients with abdominal-type of HSP are mainly young adults.So we must be more alert to abdominal-type of HSP when facing young patients with abdominal emergency.Abdominal-pain-manifesting HSP patients are mostly mixed-type cases.Gastrointestinal endoscopy is specific and might provide valuable clues for early diagnosis.