摘要
Abstract
Objective To investigate the evaluation indicators for the efficacy of thalidomide combined with danazol in the treatment of myelodysplastic syndrome(MDS).Methods A total of 112 patients with MDS admitted to the hospital from January 2018 to May 2020 were selected,all of whom were treated with Thalidomide Tablets combined with Danazol Capsules orally for three months.They were divided into the effective group(91 cases)and the ineffective group(21 cases)based on the efficacy.The white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),ratio of bone marrow blasts,T cell immunoglobulin mucin 3(Tim3),interleukin-32(IL-32),programmed death-1/programmed death-ligand 1(PD-1/PD-L1)levels in the two groups were compared.Pearson correlation analysis was used to predict the correlation among peripheral blood Tim3,IL-32 and PD-1/PD-L1 before and after treatment,as well as their correlation with WBC,Hb,PLT and the ratio of bone marrow blasts.The application value of the above peripheral blood indicators in the efficay analysis was evaluated.Results Compared with those in the ineffective group,the WBC,Hb and PLT levels in the effective group significantly increased after treatment,the ratio of bone marrow blasts significantly decreased(P<0.05),and the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels significantly decreased(P<0.05).Before and after treatment,the patients' peripheral blood Tim3 showed a significantly positive correlation with IL-32 and PD-1/PD-L1 levels respectively,and IL-32 showed a significantly positive correlation with PD-1/PD-L1 level respectively(P<0.05).Before and after treatment,the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels showed a significantly negative correlation with WBC,Hb and PLT levels,and a significantly positive correlation with the ratio of bone marrow blasts respectively(P<0.05).Before and after treatment,the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels showed a significant correlation with the efficacy of thalidomide combined with danazol in the treatment of MDS(P<0.05).The combined evaluation of peripheral blood Tim3,IL-32 and PD-1/PD-L1 showed a larger area under the drug-time curve that thalidomide combined with danazol might be ineffective in the treatment of MDS(0.885)than their single evaluation,with the sensitivity and specificity of 76.19%and 92.31%respectively.Conclusion Thalidomide combined with danazol in the treatment of MDS can effectively downregulate the peripheral blood Tim3,IL-32 and PD-1/PD-L1 levels,and comprehensive analysis of the three indicator levels can help evaluate this efficacy.关键词
骨髓增生异常综合征/沙利度胺/达那唑/T淋巴细胞免疫球蛋白黏液素3/白细胞介素32/程序性死亡因子-1/程序性死亡因子-1配体/疗效评估Key words
myelodysplastic syndrome/thalidomide/danazol/T cell immunoglobulin mucin 3/interleukin-32/programmed death-1/programmed death-ligand 1/efficacy evaluation分类
医药卫生
