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目的:评价反应停联合VPD方案治疗难治及复发性多发性骨髓瘤(MM)的临床疗效并测定反应停联合VPD方案治疗前后血清VEGF水平的变化。方法:用前瞻性设置对照的研究方法将纳入研究的48例难治及复发性MM病例分为治疗组与对照组,治疗组予以反应停400～600mg/d,每4～5周联合VPD方案一次,3至6月后作评价;对照组单纯予以VPD方案。两组治疗前和治疗后3月与6月分别测定患者血清中血管内皮生长因子(VEGF)水平。用统计软件STATA5.0采用卡方检验完成全部统计分析。结果:治疗组24例,总有效率83.33%,对照组24例,总有效率54.17%(P<0.05)。治疗组24例患者在反应停参与治疗前血中VEGF水平为376.21±20.35pg/ml、治疗后3月为238.52±14.23pg/ml(P<0.05)、治疗后6月为149.78±10.36pg/ml(P<0.01)。对照组24例患者治疗前血中VEGF水平为377.97±19.22pg/ml、治疗后3月368.19±19.57pg/ml(P>0.05)、治疗后6月为357.83±18.99pg/ml(P>0.05)。结论:反应停联合VPD方案治疗难治及复发性多发性骨髓瘤疗效较好,副作用较小,可明显降低多发性骨髓瘤患者血清VEGF水平。
OBJECTIVE: To evaluate the clinical efficacy of VPD combined with VPD regimen in the treatment of refractory and recurrent multiple myeloma (MM) and to determine the change of serum VEGF level before and after the combination of VPD and VPD. METHODS: Forty-eight refractory and recurrent MM cases enrolled in the study were divided into treatment and control groups with a prospective, prospective, controlled study. Patients in the treatment group responded to 400-600 mg / d every 4 to 5 weeks in combination with the VPD regimen Once, from March to June for evaluation; control group simply given VPD program. Serum levels of vascular endothelial growth factor (VEGF) were measured in both groups before and 3 and 6 months after treatment. Using statistical software STATA5.0 using chi-square test to complete all statistical analysis. Results: The treatment group of 24 cases, the total effective rate was 83.33%, the control group of 24 patients, the total effective rate was 54.17% (P <0.05). 24 patients in the treatment group had a serum VEGF level of 376.21 ± 20.35pg / ml before treatment and 238.52 ± 14.23pg / ml in March after treatment (P <0.05), and 149.78 ± 10.36pg / ml (P <0.01). The blood level of VEGF in the control group was 377.97 ± 19.22pg / ml before treatment, 368.19 ± 19.57pg / ml in March after treatment (P> 0.05), and 357.83 ± 18.99pg / ml in June after treatment (P> 0.05 ). CONCLUSION: The combination therapy with VPD regimen has a good curative effect on refractory and recurrent multiple myeloma with less side effects, which can significantly reduce the serum VEGF level in patients with multiple myeloma.