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目的:研究双嘧达莫对淋巴瘤患者外周血血小板活化标志PAC-1和CD62p表达水平及近期疗效的影响。方法:选择42例淋巴瘤患者随机分为单纯化疗组(单纯组)和化疗+双嘧达莫组(联合组)。联合组患者在化疗基础上应用双嘧达莫100 mg/d;另选择15名健康体检者作为对照组。应用流式细胞术(FCM)分别于化疗d0、d3、d7及d14检测淋巴瘤患者外周血血小板PAC-1和CD62p的表达水平。结果:1)淋巴瘤患者外周血PAC-1和CD62p表达水平较对照组明显升高,P<0.01。2)单纯组在化疗d0、d3的PAC-1表达较化疗d14明显升高,P<0.05和0.01;化疗d3的CD62p表达较化疗d0、d14明显增高,P<0.01。联合组在化疗d14的PAC-1表达水平较化疗d0、d3明显降低,P<0.01;化疗d14的CD62p表达较化疗d0、d3降低,P<0.05和0.01。3)联合组在化疗d7、d14的PAC-1以及化疗d3、d7、d14的CD62p与单纯组比较表达下降,P<0.05和0.01。4)治疗4个周期后单纯组和联合组总缓解率(CR+PR)分别为78.95%(15/19)和82.35%(14/17),两组间近期疗效比较差异无统计学意义,χ2=1.204,P>0.05。结论:淋巴瘤患者常出现外周血小板活化,双嘧达莫能有效地抑制患者外周血PAC-1和CD62p表达,从而抑制血小板的活化。
OBJECTIVE: To study the effect of dipyridamole on the expression of platelet activation markers PAC-1 and CD62p in patients with lymphoma and their short-term efficacy. Methods: Forty-two patients with lymphoma were randomly divided into chemotherapy group (simple group) and chemotherapy plus dipyridamole group (combination group). The combination group was treated with dipyridamole 100 mg / d on the basis of chemotherapy. Fifteen healthy subjects were selected as the control group. Flow cytometry (FCM) were used to detect the expression of platelet PAC-1 and CD62p in peripheral blood of patients with lymphoma on day 0, day d3, day d7 and day d14 respectively. Results: 1) The expression of PAC-1 and CD62p in peripheral blood of patients with lymphoma was significantly higher than that of the control group (P <0.01.2). The expression of PAC-1 in the chemotherapy group at d0 and d3 was significantly higher than that at chemotherapy d14 (P < 0.05 and 0.01 respectively. The expression of CD62p on d3 was significantly higher than that on chemotherapy d0 and d14 (P <0.01). The expression of PAC-1 in the combined group was significantly lower than that in the chemotherapy group (d0 and d3, d <0.01), and the expression of CD62p in the chemotherapy group was lower than that in the chemotherapy group (d0 and d3, P <0.05 and 0.01.3) (P <0.05 and 0.01.4). The total remission rate (CR + PR) of PAC-1 and chemotherapy group at d3, d7 and d14 was 78.95% (15/19) and 82.35% (14/17), respectively. There was no significant difference in short-term curative effect between the two groups (χ2 = 1.204, P> 0.05). CONCLUSION: Peripheral platelet activation is frequently observed in patients with lymphoma. Dipyridamole can effectively inhibit the expression of PAC-1 and CD62p in peripheral blood and inhibit the activation of platelets.