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目的探讨氯屈膦酸二钠(clodronate disodium,商品名固令)联合化疗治疗多发性骨髓瘤(multiple myeloma,MM)的溶骨性病变的疗效。方法治疗组20例予氯屈膦酸二钠2400mg/日口服,同时予MP或M2方案化疗;对照组予MP或M2方案化疗。骨痛的缓解和血钙的下降作为评价指标。结果治疗组和对照组用药前均有骨痛,治疗后,治疗组完全缓解7例,部分缓解9例,有效率80%;对照组完全缓解2例,部分缓解6例,有效率44.4%,治疗组有效率高于对照组(P=0.023)。治疗组血钙升高7例,治疗后均降至正常范围,下降率为100%;对照组血钙升高5例,治疗后仅2例降至正常范围,下降率为40%。毒副作用方面,两组病人在用药过程中均未见有严重不良反应,病人耐受性良好。结论氯屈膦酸二钠是一种治疗多发性骨髓瘤伴骨痛和高钙血症的有效药物。
Objective To investigate the therapeutic effect of clodronate disodium combined with chemotherapy on osteolytic lesions of multiple myeloma (MM). Methods Twenty patients were treated with chlorpromazine disodium 2400 mg / day orally at the same time. The patients in the treatment group were treated with MP or M2 regimen and the control group were treated with MP or M2 regimen. Relieve bone pain and decreased serum calcium as an indicator. Results The treatment group and the control group had bone pain before treatment. After treatment, the treatment group completely relieved 7 cases and partially relieved 9 cases, the effective rate was 80%. In the control group, 2 cases were completely relieved, 6 cases partially relieved, the effective rate was 44.4% The treatment group was more effective than the control group (P = 0.023). Serum calcium in treatment group increased in 7 cases, after treatment were reduced to the normal range, the rate of decline was 100%; control group, 5 cases of elevated serum calcium, after treatment, only 2 cases fell to the normal range, the rate of decline was 40%. Toxic side effects, the two groups of patients in the course of medication were not seen in serious adverse reactions, the patient was well tolerated. Conclusion Clodronate disodium is an effective drug for the treatment of multiple myeloma with bone pain and hypercalcemia.