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目的:分析系统性淀粉样变临床特点及不同方案治疗情况下的临床疗效,提高对淀粉样变的治疗认识。方法:回顾分析哈医大一院及大庆油田总医院近10年43例淀粉样变药物治疗的临床资料,总结不同临床特点下药物疗效和预后。结果:2组药物有效率分别为54.90%、48.57%,组间无差异性(P>0.05)。原发性淀粉样变和继发性淀粉样变总有效率分别为32.72%、74.19%,组间具有差异性(P<0.05)。不同年龄组间有效率具有差异性(P<0.05)。不同治疗周期有效率无差异性(P>0.05)。不同病变系统有效率分别为单系统75.00%,2个系统45.00%,3个系统29.41%,4个及以上系统5.88%,组间具有差异性(P<0.05)。器官功能代偿期与失代偿期的有效率分别为61.76%、30.76%,组间具有差异性(P<0.05)。结论:药物治疗系统性淀粉样变性具有确切的临床疗效,对继发性淀粉样变的临床疗效优于原发性淀粉样变。药物治疗的最佳周期为6个月以内,延长治疗时间不能提高临床疗效而会增加副作用。随着病变器官和系统的增加及器官功能失代偿,药物疗效降低。
OBJECTIVE: To analyze the clinical features of systemic amyloidosis and the clinical efficacy under different treatment scenarios, and to improve the understanding of the treatment of amyloidosis. Methods: The clinical data of 43 patients with amyloidosis treated in the First Hospital of Harbin Medical University and the General Hospital of Daqing Oilfield in the past 10 years were retrospectively analyzed. The curative effect and prognosis of the patients under different clinical features were summarized. Results: The effective rates of two groups were 54.90% and 48.57% respectively, there was no difference between the two groups (P> 0.05). The total effective rates of primary amyloidosis and secondary amyloidosis were 32.72% and 74.19%, respectively, with a significant difference between the two groups (P <0.05). There were significant differences in efficiency among different age groups (P <0.05). There was no difference in the efficiency of different treatment cycles (P> 0.05). The effective rates of different pathological systems were 75.00% for single system, 45.00% for 2 systems, 29.41% for 3 systems, and 5.88% for 4 or more systems, respectively. There were significant differences between groups (P <0.05). The effective rates of organ decompensation and decompensation were 61.76% and 30.76%, respectively, with significant differences (P <0.05). Conclusion: The drug treatment of systemic amyloidosis has the exact clinical efficacy, the clinical efficacy of secondary amyloidosis is superior to primary amyloidosis. The best cycle of drug treatment within 6 months, prolonged treatment time can not improve clinical efficacy and increase side effects. With the lesion organ and system increase and organ decompensation, drug efficacy decreased.