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目的探讨硼替佐米联合方案治疗多发性骨髓瘤肾病的疗效及安全性。方法选取2014年9月~2016年9月采用化疗方案治疗多发性骨髓瘤肾病患者41例,随机分为观察组和对照组。对照组23例采用常规化疗方案,观察组18例采用硼替佐米联合常规化疗方案。以β2-微球蛋白(β2-MG)、肌酐清除率为观察指标,观察化疗前后肾功能的变化,同时观察原发病缓解情况,记录相关不良反应。结果观察组肾功能改善率(66.7%)明显优于对照组(30.4%);观察组缓解率(83.3%)亦高于对照组(47.8%);观察组消化道反应发生率(27.8%)、骨髓抑制发生率(33.3%)、感染发生率(44.4%)均低于对照组,但观察组周围神经病变的发生率(38.9%)却高于对照组(34.8%)。结论硼替佐米联合方案治疗多发性骨髓瘤肾病患者,可明显改善患者肾功能情况,提高原发病缓解率,减少相关不良反应,其疗效和安全性明显优于常规化疗方案。
Objective To investigate the efficacy and safety of bortezomib in the treatment of multiple myeloma and nephropathy. Methods From September 2014 to September 2016, 41 patients with multiple myeloma and nephropathy treated with chemotherapy were randomly divided into observation group and control group. Twenty-three patients in the control group received conventional chemotherapy and 18 patients in the observation group received bortezomib plus conventional chemotherapy. To β2-microglobulin (β2-MG), creatinine clearance rate as an indicator to observe changes in renal function before and after chemotherapy, while observing the relief of the original disease, record the adverse reactions. Results The improvement rate of renal function in observation group (66.7%) was significantly better than that in control group (30.4%). The remission rate in observation group was also higher than that in control group (83.8%). The incidence of digestive tract reaction in observation group was 27.8% , Bone marrow suppression (33.3%) and infection (44.4%) were lower than the control group, but the incidence of peripheral neuropathy in the observation group (38.9%) was higher than that of the control group (34.8%). Conclusion The combination of bortezomib in patients with multiple myeloma and renal disease can significantly improve renal function, improve the rate of the original disease and reduce the adverse reactions, its efficacy and safety is superior to conventional chemotherapy.