摘要
目的探讨硼替佐米联合来那度胺、地塞米松治疗多发性骨髓瘤的临床效果。方法抽取2019年1月至2021年12月濮阳市人民医院收治的多发性骨髓瘤患者62例,按随机数字表法分为研究组与对照组,每组31例。对照组采用硼替佐米、地塞米松治疗,研究组在对照组基础上加用来那度胺进行治疗。比较两组临床疗效,比较两组治疗前后免疫细胞因子(T淋巴细胞亚群CD3^(+)、CD4^(+))、骨代谢调节因子[核因子κB受体活化因子配体(RANKL)、人抗酒石酸磷酸酶(TRACP-5b)]、M蛋白、β2微球蛋白水平及骨髓浆细胞比率。结果研究组总有效率为74.19%(23/31),高于对照组的48.39%(15/31),P<0.05。治疗后,两组CD3^(+)、CD4^(+)均较治疗前升高(P均<0.05),且研究组高于对照组(P<0.05)。治疗后,两组RANKL、TRACP-5b、M蛋白、β2微球蛋白、骨髓浆细胞比率均较治疗前降低(P均<0.05),且研究组低于对照组(P<0.05)。结论硼替佐米联合来那度胺、地塞米松治疗多发性骨髓瘤,可改善患者的免疫功能和骨代谢调节因子水平,并可调节M蛋白、β2微球蛋白表达,降低骨髓细胞比率,临床效果较好。
Objective To investigate the effect of bortezomib combined with lenalidomide and dexamethasone in the treatment of multiple myeloma.Methods A total of 62 patients with multiple myeloma treated in Puyang People’s Hospital from January 2019 to December 2021 were selected,and they were divided into study group and control group according to random number table method,with 31 cases in each group.The control group was treated with bortezomib and dexamethasone,and the study group was treated with lenalidomide based on the treatment of the control group.The clinical efficacy of the two groups were compared;the immune cytokines including T lymphocyte subsets cluster of differentiation 3^(+)(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+)),bone metabolism regulators including receptor activator of nuclear factor-κB ligand(RANKL)and human tartrate-resistant acid phosphatase 5b(TRACP-5b),M protein,β2 microglobulin,and bone marrow plasma cell ratio were compared between the two groups.Results The total effective rate of the study group was 74.19%(23/31),which was higher than the 48.39%(15/31)of the control group(P<0.05).After treatment,CD3^(+)and CD4^(+)in both groups were higher than before treatment(all P<0.05),and those indexes in the study group were higher than those in the control group(P<0.05).After treatment,the RANKL,TRACP-5b,M protein,β2 microglobulin,and the ratio of bone marrow plasma cells in the two groups were all lower than those before treatment(all P<0.05),and those indexes in the study group were lower than those in the control group(P<0.05).Conclusions Bortezomib combined with lenalidomide and dexamethasone in the treatment of multiple myeloma can improve immune function and the level of bone metabolism regulators,regulate the expression of M protein andβ2 microglobulin,and reduce the ratio of bone marrow cells,with good clinical effects.
作者
纪国超
孙富英
李志春
Ji Guochao;Sun Fuying;Li Zhichun(Department of Hematology,Puyang People’s Hospital,Puyang 457000,China)
出处
《中国实用医刊》
2022年第21期86-89,共4页
Chinese Journal of Practical Medicine
