目的 探讨多柔比星联合替莫唑胺治疗脑胶质瘤患者的安全性和有效性。方法 选择2016年11月—2017年11月在商丘市第三人民医院就诊的脑胶质瘤患者65例，随机分成对照组（32例）和治疗组（33例）。对照组患者口服替莫唑胺胶囊，75 mg/（m²·d）治疗42 d；治疗组患者在对照组基础上静脉滴注盐酸多柔比星注射液，前3 d剂量为20 mg/m²，停药21 d后重复上述给药，24 d为1个周期，连续治疗2个周期。观察两组患者临床疗效，同时比较治疗前后两组患者卡氏功能状态评分（KPS）、中位复发时间和2年生存率，及血清基质金属蛋白酶-2（MMP-2）、肿瘤特异性生长因子（TSGF）和胶质纤维酸性蛋白（GFAP）水平。结果 治疗后，对照组患者客观缓解率和疾病控制率分别为34.38%、53.13%，均分别显著低于治疗组患者的60.61%、78.79%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组KPS评分、中位复发时间和2年生存率均要明显高于对照组（P<0.05）。治疗后，两组患者血清MMP-2、TSGF水平明显降低，而GFAP水平明显升高（P<0.05），且治疗后治疗组患者MMP-2、TSGF和GFAP水平明显好于对照组（P<0.05）。结论 盐酸多柔比星联合替莫唑胺治疗脑胶质瘤疗效显著，且能够显著改善患者复发率与生存质量，具有一定的临床推广应用价值。

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

河北省卫生厅青年基金项目（20150036）