目的 探討多柔比星聯(lián)合替莫唑胺治療腦膠質(zhì)瘤患者的安全性和有效性。方法 選擇2016年11月—2017年11月在商丘市第三人民醫(yī)院就診的腦膠質(zhì)瘤患者65例，隨機(jī)分成對(duì)照組（32例）和治療組（33例）。對(duì)照組患者口服替莫唑胺膠囊，75 mg/（m²·d）治療42 d；治療組患者在對(duì)照組基礎(chǔ)上靜脈滴注鹽酸多柔比星注射液，前3 d劑量為20 mg/m²，停藥21 d后重復(fù)上述給藥，24 d為1個(gè)周期，連續(xù)治療2個(gè)周期。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者卡氏功能狀態(tài)評(píng)分（KPS）、中位復(fù)發(fā)時(shí)間和2年生存率，及血清基質(zhì)金屬蛋白酶-2（MMP-2）、腫瘤特異性生長(zhǎng)因子（TSGF）和膠質(zhì)纖維酸性蛋白（GFAP）水平。結(jié)果 治療后，對(duì)照組患者客觀緩解率和疾病控制率分別為34.38%、53.13%，均分別顯著低于治療組患者的60.61%、78.79%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組KPS評(píng)分、中位復(fù)發(fā)時(shí)間和2年生存率均要明顯高于對(duì)照組（P<0.05）。治療后，兩組患者血清MMP-2、TSGF水平明顯降低，而GFAP水平明顯升高（P<0.05），且治療后治療組患者M(jìn)MP-2、TSGF和GFAP水平明顯好于對(duì)照組（P<0.05）。結(jié)論 鹽酸多柔比星聯(lián)合替莫唑胺治療腦膠質(zhì)瘤療效顯著，且能夠顯著改善患者復(fù)發(fā)率與生存質(zhì)量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the safety and efficacy of doxorubicin combined with temozolomide in treatment of glioma. Methods Patients (65 cases) with glioma in the Third People's Hospital of Shangqiu from November 2016 to November 2017 were randomly divided into control (32 cases) and treatment (33 cases) groups. Patients in the control group were po administered with Temozolomide Capsules, 75 mg/(m²·d) for 42 d. Patients in the treatment group were iv administered with Doxorubicin Hydrochloride Injection on the basis of the control group, 20 mg/m² for the first three days, then repeated the administration after withdrawal 21 d, 24 days was one treatment cycle, and they were treated for two cycles. After treatment, the clinical efficacy was evaluated, and the KPS scores, median relapse time and 2-year survival rate, and serum levels of MMP-2, TSGF and GFAP in two groups before and after treatment were compared. Results After treatment, the objective reaction rate and disease control rate in the control group were 34.38% and 53.13%, which were significantly lower than 60.61% and 78.79% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the KPS scores, median relapse time and 2-year survival rate in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the serum levels of MMP-2 and TSGF in two groups were significantly decreased, but the GFAP levels were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Doxorubicin combined with temozolomide in treatment of glioma is effective, can significantly improve the recurrence rate and quality of life which has a certain clinical application value.

R971

河北省衛(wèi)生廳青年基金項(xiàng)目（20150036）