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目的探讨沙利度胺联合硼替佐米治疗多发性骨髓瘤(MM)的临床效果。方法对2013年12月至2016年5月内蒙古医科大学附属医院收治的MM患者82例进行分析。根据患者病情分为A组(沙利度胺)35例,B组(沙利度胺+硼替佐米)47例。比较两组患者治疗后总反应率、不良反应情况。结果 B组治疗后第2、4周总反应率分别为51.1%、85.1%,明显高于A组的28.6%、60.0%,差异均有统计学意义(P<0.05)。A组不良反应发生率为22.9%,低于B组的48.9%,差异有统计学意义(P<0.05)。治疗后B组的B2微球蛋白(β2-GM)、M蛋白和MM浆细胞数分别为(2 231.37±0.29)μg/L、(20.36±9.45)%、(11.32±5.35)%,均明显低于A组的(4 265.34±0.16)μg/L、(32.95±0.29)%和(23.83±6.77)%,而血红蛋白(82.25±13.76)g/L显著高于A组(76.41±14.33)g/L,差异均有统计学意义(P<0.05);治疗后B组的血沉、血尿酸、血钙离子分别为(74.04±30.11)mm/h、(289.12±137.18)mmol/L和(2.31±0.26)mmol/L,均低于A组的(91.32±33.52)mm/h、(351.55±139.34)mmol/L和(2.55±4.37)mmol/L,而总蛋白水平(84.86±10.2)g/L高于A组的(80.05±16.3)g/L,差异均具有统计学意义(P<0.05)。结论沙利度胺联合硼替佐米治疗多发性骨髓瘤可获得较好的中短期临床疗效,可减少沙利度胺和硼替佐米的单独使用剂量,但该方案的不良反应发生率较高,对于维持、巩固治疗需要进一步深入研究。
Objective To investigate the clinical effect of thalidomide combined with bortezomib in the treatment of multiple myeloma (MM). Methods Eighty-two MM patients admitted to the Affiliated Hospital of Inner Mongolia Medical University from December 2013 to May 2016 were analyzed. According to the patient’s condition, they were divided into group A (thalidomide) 35 cases and group B (thalidomide + bortezomib) 47 cases. The two groups of patients after treatment, the overall response rate, adverse reactions. Results The total reaction rates in group B at the second and fourth week after treatment were 51.1% and 85.1%, respectively, which were significantly higher than those in group A (28.6% and 60.0%, both P <0.05). The incidence of adverse reactions in group A was 22.9%, lower than 48.9% in group B, the difference was statistically significant (P <0.05). After treatment, the numbers of B2 microglobulin (B2-GM), M protein and myeloid plasma in group B were (2131.37 ± 0.29) μg / L and (20.36 ± 9.45)%, (11.32 ± 5.35)% Which was significantly lower than that in group A (4 265.34 ± 0.16) μg / L, (32.95 ± 0.29)% and (23.83 ± 6.77)% respectively, and hemoglobin (82.25 ± 13.76) g / L was significantly higher than that in group A (76.41 ± 14.33 g (P <0.05). After treatment, the levels of erythrocyte sedimentation rate, blood uric acid and blood calcium in group B were (74.04 ± 30.11) mm / h, (289.12 ± 137.18) mmol / L and (91.32 ± 33.52) mm / h, (351.55 ± 139.34) mmol / L and (2.55 ± 4.37) mmol / L, respectively, while the total protein level was 84.86 ± 10.2 / L was higher than that in A group (80.05 ± 16.3) g / L, the differences were statistically significant (P <0.05). Conclusions Thalidomide combined with bortezomib in the treatment of multiple myeloma can achieve better clinical efficacy in short and medium term, and can reduce the dosage of thalidomide and bortezomib alone, but the incidence of adverse reactions in this regimen is high, To maintain and consolidate the treatment needs further study.