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目的:探讨复方丹参注射液联合伊马替尼对急性淋巴细胞白血病(ALL)患者P-糖蛋白、P53蛋白水平及心血管功能的影响。方法:随机数字表格法将纳入标准的80例ALL患者分为对照组与观察组,各40例,所有患者均接受VDCP化疗方案治疗,此外对照组加以伊马替尼治疗,观察组则加以复方丹参注射液联合伊马替尼治疗,比较两组近期疗效、不良反应、治疗前后外周血象、免疫功能及心率变异性(HRV)指标,同时治疗前后通过流式细胞仪测定P-糖蛋白及P53蛋白水平。结果:观察组治疗有效率90.00%,较对照组的80.00%差异无统计学意义(P<0.05)。与治疗前比较,治疗后两组WBC水平显著下降,Hb、PLT、RBC水平显著上升(P<0.05)。观察组治疗后WBC、Hb、RBC、CD_3~+、CD_4~+、CD_4~+/CD_8~+、SDNN、SDANN、RMSSD、PNN50水平均明显高于对照组(P<0.05)。观察组治疗后P53阳性表达率较治疗前明显下降,较对照组明显低(P<0.05)。观察组肝功能异常发生率明显低于对照组(P<0.05)。结论:复方丹参注射液联合伊马替尼治疗ALL疗效明确,能有效减少伊马替尼+化疗不良反应,降低P-糖蛋白及P53蛋白阳性表达率,且对患者免疫功能、心率变异性有一定的改善作用。
Objective: To investigate the effects of compound Danshen injection plus imatinib on P-glycoprotein, P53 protein and cardiovascular function in patients with acute lymphoblastic leukemia (ALL). Methods: Eighty patients with ALL who were enrolled in the standard were divided into control group and observation group by random number table method. All 40 patients were treated with VDCP chemotherapy. In addition, the control group was treated with imatinib, while the observation group was given compound Danshen injection combined with imatinib treatment, the two groups of short-term efficacy, adverse reactions, before and after treatment of peripheral blood, immune function and heart rate variability (HRV) indicators, before and after treatment by flow cytometry P-glycoprotein and P53 Protein level. Results: The effective rate of the observation group was 90.00%, which was not significantly different from that of the control group (80.00%) (P <0.05). Compared with those before treatment, the levels of WBC, Hb, PLT and RBC in both groups were significantly decreased (P <0.05) after treatment. The levels of WBC, Hb, RBC, CD_3 ~ +, CD_4 ~ +, CD_4 ~ + / CD_8 ~ +, SDNN, SDANN, RMSSD and PNN50 in the observation group were significantly higher than those in the control group (P <0.05). The positive expression rate of P53 in observation group after treatment was significantly lower than that before treatment, which was significantly lower than that in control group (P <0.05). The incidence of liver dysfunction in observation group was significantly lower than that in control group (P <0.05). Conclusion: The compound salvia miltiorrhiza injection combined with imatinib treatment of ALL has a definite curative effect, which can effectively reduce the adverse reaction of imatinib and chemotherapy, and reduce the positive expression rate of P-glycoprotein and P53 protein. And the immune function, heart rate variability Certain improvement effect.