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[目的]探讨改良VAD方案治疗多发性骨髓瘤的疗效。[方法]32例多发骨髓瘤患者随机分为两组,均应用阿霉素和长春新碱。研究组16例给予甲基强的松龙80～120mg,d1～4、d9～12、d17～20静脉滴注,对照组16例给予地塞米松40mg口服,用药时间同研究组。[结果]研究组总有效率81%(13/16),对照组总有效率88%(14/16),两组疗效无显著性差异(P>0.05);感染发生率治疗组12.5%,对照组31.2%;消化道出血发生率治疗组6%,对照组19%;研究组感染及消化道出血发生率明显低于对照组(P<0.05)。[结论]以静脉应用甲基强的松龙的改良VAD方案治疗多发性骨髓瘤疗效较好,毒副作用较传统VAD方案轻。
[Objective] To investigate the curative effect of modified VAD regimen in treating multiple myeloma. [Method] Thirty-two patients with multiple myeloma were randomly divided into two groups. All of them were treated with doxorubicin and vincristine. The study group was given 16 methylprednisolone 80 ~ 120mg, d1 ~ 4, d9 ~ 12, d17 ~ 20 intravenous drip, 16 cases in the control group were given dexamethasone 40mg orally, the same time with the study group. [Results] The total effective rate was 81% (13/16) in the study group and 88% (14/16) in the control group, with no significant difference between the two groups (P> 0.05). The incidence of infection in the treatment group was 12.5% The control group was 31.2%; the incidence of gastrointestinal bleeding was 6% in the treatment group and 19% in the control group; the incidence of infection and gastrointestinal bleeding in the study group was significantly lower than that in the control group (P <0.05). [Conclusion] The treatment of multiple myeloma with intravenous methylprednisolone modified VAD is better and the toxicity is lower than that of traditional VAD.