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目的:分析地西他滨联合阿柔比星+阿糖胞苷+重组人粒细胞刺激因子(CAG)方案治疗高危骨髓增生异常综合征(MDS)的效果。方法:抽取2017年1月至2020年10月安阳地区医院高危MDS患者60例，按随机数字表法分为联合组(30例)与单一组(30例)，单一组采用CAG方案治疗，联合组采用地西他滨联合CAG方案治疗。比较两组疗效、治疗前后血常规、T淋巴细胞亚群(CD3n +、CD8n +)程序性死亡受体1(PD-1)表达、细胞毒性T淋巴细胞相关抗原4(CTLA-4)表达，比较不良反应发生率。n 结果:联合组总缓解率(93.33%)高于单一组(73.33%)，差异有统计学意义(n P<0.05)；治疗后，两组血红蛋白、血小板计数均较治疗前增高，且联合组高于单一组，差异有统计学意义(n P<0.05)；治疗后，两组PD-1n +CD3n +T、PD-1n +CD8n +T表达均较治疗前降低，且联合组低于单一组，差异有统计学意义(n P<0.05)；治疗后，两组CTLA-4n +CD3n +T、CTLA-4n +CD8n +T表达均较治疗前降低，且联合组低于单一组，差异有统计学意义(n P0.05)。n 结论:地西他滨联合CAG方案治疗高危MDS患者效果显著，可调节T淋巴细胞亚群中PD-1、CTLA-4表达，改善血常规水平，且未明显增加不良反应发生风险，可为临床治疗高危MDS患者提供科学依据。“,”Objective:To analyze the efficacy of decitabine combined with aclarubicin+ cytarabine+ recombinant human granulocyte stimulating factor (CAG) regimen in the treatment of high-risk myelodysplastic syndrome (MDS).Methods:A total of 60 high-risk MDS patients in the Anyang District Hospital of Puyang City from January 2017 to October 2020 were selected, and divided into combined group (n n=30) and single group (n n=30) according to the random number table method. The single group was treated with CAG regimen, and the combined group was treated with decitabine combined with CAG regimen. The curative effects of the two groups, blood routine before and after treatment, T lymphocyte subsets programmed death receptor 1 (PD-1) expression, cytotoxic T lymphocyte associated antigen 4 (CTLA-4) expression were compared between the two groups. Compare the incidence of adverse reactions.n Results:The total response rate of the combined group (93.33%) higher than that of the single group (73.33%), the difference was statistically significant (n P<0.05). After treatment, the hemoglobin and platelet counts of the two groups were higher than before treatment, and the combined group was higher than the single group, the difference was statistically significant (n P<0.05). After treatment, the expressions of PD-1n + CD3n + T and PD-1n + CD8n + T in the two groups were lower than before treatment, and the combined group was lower than the single group, the difference was statistically significant (n P<0.05). After treatment, the expressions of CTLA-4n + CD3n + T and CTLA-4n + CD8n + T in the two groups were lower than before treatment, and the combined group was lower than the single group, the difference was statistically significant (n P0.05).n Conclusions:Decitabine combined with CAG regimen is effective in the treatment of high-risk MDS patients. It can regulate the expression of PD-1 and CTLA-4 in T lymphocyte subsets, improve blood routine levels, and does not significantly increase the risk of adverse reactions. It can provide scientific basis for clinical treatment of high-risk MDS patients.