摘要
目的观察TD(沙利度胺+地塞米松)方案联合硼替佐米治疗多发性骨髓瘤(MM)患者的临床疗效及安全性。方法选取2018年4月至2020年4月我院收治的MM患者86例,随机分为观察组和对照组,每组43例。对照组患者采用TD方案治疗,观察组患者采用TD方案联合硼替佐米治疗,治疗28 d为1个周期,两组患者均治疗3个周期。比较两组患者的治疗总有效率;检测比较两组患者治疗前后的血清人Dickkopf-1基因(DKK-1)、骨保护素(OPG)、血管内皮生长因子(VEGF)、白介素(IL)-6、IL-17水平;比较两组患者治疗过程中的不良反应发生情况。结果治疗3个周期,观察组患者的治疗总有效率(88.4%)显著高于对照组(69.8%),差异有统计学意义(P<0.05)。治疗3个周期后,两组患者的血清DKK-1水平均显著降低,观察组患者的水平显著低于对照组;两组患者的OPG水平均显著升高,观察组患者的水平显著高于对照组;两组患者的血清VEGF、IL-6、IL-17水平均显著降低,观察组患者的水平显著低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论TD方案联合硼替佐米治疗多发性骨髓瘤患者的临床疗效显著,可明显改善患者骨代谢状况,降低炎症反应水平,治疗安全性良好。
Objective To observe the efficacy and safety of thalidomide+dexamethasone(TD)regimen combined with bortezomib in the treatment of patients with multiple myeloma(MM).Methods A total of 86 MM patients admitted to our hospital from April 2018 to April 2020 were enrolled,and they were randomly divided into observation group and control group,with 43 cases in each group.The control group was treated with TD regimen,while the observation group was treated with TD regimen combined with bortezomib,with 28 days as a cycle of treatment and 3 treatment cycles for both groups.The total effective rate was compared between the two groups.The human Dickkopf-1(DKK-1)gene,osteoprotegerin(OPG),vascular endothelial growth factor(VEGF),and interleukin(IL)-6 and IL-17 levels were detected and compared between the two groups.The occurrence of adverse reactions during the treatment was compared between the two groups.Results After 3 cycles of treatment,the total effective rate of the observation group(88.4%)was significantly higher than that of the control group(69.8%),with a statistically significant difference(P<0.05).After 3 cycles of treatment,the serum DKK-1 levels of the two groups significantly decreased,and the observation group yielded lower level in comparison with the control group;the OPG levels of the two groups significantly increased,and the observation group yielded higher level in comparison with the control group.The serum VEGF,IL-6,and IL-17 levels of the two groups significantly decreased,while the observation group yielded lower levels in comparison with the control group,with statistically significant differences(P<0.05).During the treatment period,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion TD regimen combined with bortezomib in treating MM patients has a prominently clinical efficacy.It can significantly improve bone metabolism,and reduce inflammation response,with high safety.
作者
叶娟
高丽
王改
YE Juan;GAO Li;WANG Gai(Department of Hematology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China)
出处
《内科》
2021年第5期581-584,共4页
Internal Medicine
基金
河南省科技攻关项目(2018020905)。
