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目的:探讨血清血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNF-α)及白细胞介素-6(IL-6)在沙利度胺联合VAD方案化疗的多发性骨髓瘤(MM)患者中的表达及临床意义。方法:将46例MM患者随机分为T-VAD组(23例)和VAD组(23例),T-VAD组患者应用VAD方案同时连续口服沙利度胺200～250mg/d联合化疗,共6个周期。VAD组患者行VAD方案化疗,共6个周期。用ELISA方法检测患者治疗前后血清VEGF、TNF-α和IL-6水平。并以26例健康人作正常对照组。结果:VAD组和T-VAD组患者治疗前血清VEGF、TNF-α和IL-6水平较正常对照组均显著升高,两组差异无统计学意义(P>0.05),与正常对照组比较差异有统计学意义,P<0.01;治疗后两组患者血清VEGF、TNF-α和IL-6水平对照差异有统计学意义(P<0.05),T-VAD组较VAD组下降更明显;两组治疗前后VEGF、TNF-α和IL-6水平差异均有统计学意义,P<0.05。T-VAD组总有效率明显高于VAD组,P<0.05。结论:MM患者血清VEGF、TNF-α和IL-6水平较正常人明显升高,T-VAD组治疗后总有效率明显高于VAD组,且T-VAD组较VAD组治疗后血清VEGF、TNF-α和IL-6水平下降更明显,对改善多发性骨髓瘤患者预后有重要作用。
Objective: To investigate the clinical value of serum vascular endothelial growth factor (VEGF), tumor necrosis factor α (TNF-α) and interleukin -6 (IL-6) in patients with multiple myeloma (MM) treated with thalidomide plus VAD regimen In the expression and clinical significance. Methods: 46 patients with MM were randomly divided into T-VAD group (23 cases) and VAD group (23 cases). Patients in T-VAD group were treated with continuous-dose thalidomide (200 ~ 250 mg / d) 6 cycles. VAD patients underwent VAD chemotherapy, a total of 6 cycles. Serum levels of VEGF, TNF-α and IL-6 in patients before and after treatment were detected by ELISA. Twenty-six healthy people were selected as normal control group. Results: The levels of VEGF, TNF-α and IL-6 in VAD group and T-VAD group before treatment were significantly higher than those in normal control group, with no significant difference between the two groups (P> 0.05) The difference was statistically significant, P <0.01; after treatment, serum VEGF, TNF-α and IL-6 levels in the two groups were significantly different (P <0.05), T-VAD group decreased more significantly than the VAD group; The levels of VEGF, TNF-α and IL-6 in the group before treatment were significantly different (P <0.05). The total effective rate of T-VAD group was significantly higher than that of VAD group, P <0.05. Conclusion: The serum levels of VEGF, TNF-α and IL-6 in MM patients were significantly higher than those in normal controls. The total effective rate in T-VAD group was significantly higher than that in VAD group. The levels of VEGF, TNF-α and IL-6 levels decreased more significantly, to improve the prognosis of multiple myeloma patients have an important role.