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目的:观察沙利度胺、环孢素联合泼尼松(TCP方案)治疗中低危骨髓增生异常综合征(MDS)的临床疗效及其对患者Th17、Th22细胞水平的影响。方法:中低危MDS住院患者68例随机分为两组各34例。观察组采用TCP方案治疗,对照组单用环孢素治疗,共治疗12周。评估两组疗效与药品不良反应,比较两组患者治疗前后Th17、Th22细胞表达水平变化。结果:治疗12周后,观察组有效率64.71%高于对照组41.18%(P<0.05)。治疗后,观察组Th17、Th22细胞水平均较治疗前降低(P<0.05),对照组仅Th17细胞水平有所降低(P<0.05);且观察组Th17、Th22细胞水平均低于对照组(P<0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:TCP方案治疗中低危MDS安全、有效,且能够通过调节Th17和Th22细胞水平改善患者免疫功能。
Objective: To observe the clinical efficacy of thalidomide and cyclosporine combined with prednisone (TCP) in the treatment of middle-low risk myelodysplastic syndrome (MDS) and its effect on Th17 and Th22 cells. Methods: 68 low-risk patients with MDS were randomly divided into two groups of 34 cases. The observation group was treated with TCP protocol and the control group with cyclosporine alone for 12 weeks. The curative effect and adverse drug reactions of the two groups were evaluated, and the changes of the expression of Th17 and Th22 cells before and after treatment were compared between the two groups. Results: After 12 weeks of treatment, the effective rate in the observation group was 64.71% higher than that in the control group (41.18%, P <0.05). After treatment, the levels of Th17 and Th22 cells in the observation group were lower than those before treatment (P <0.05), while the levels of Th17 cells in the control group were decreased (P <0.05); and the levels of Th17 and Th22 cells in the observation group were lower than those in the control group P <0.05). There was no significant difference between the two groups in the incidence of adverse drug reactions (P> 0.05). CONCLUSION: TCP regimen is safe and effective in treating mid-low-risk MDS and can improve immune function of patients by regulating the levels of Th17 and Th22 cells.