多发性骨髓瘤疼痛分析及治疗

Analysis of Multiple Myeloma Pain and Its Treatment

目的总结多发性骨髓瘤(MM)的疼痛原因,探索最佳治疗方法。方法对76例骨髓瘤患者进行回顾性分析,患者均伴有中重度骨骼疼痛,按照不同的治疗方法分为4组,比较4组的疗效。结果A组26例,骨痛完全缓解8例,部分缓解13例,无效5例;B组20例,骨痛完全缓解3例,部分缓解5例,无效12例;C组10例,骨痛完全缓解2例,部分缓解3例,无效5例;D组20例,骨痛完全缓解10例,部分缓解7例,无效3例,4种治疗方法的疗效间差异有统计学意义(P<0.05)。骨骼疼痛程度与瘤细胞数、血钙水平呈正相关(P<0.05),与免疫分型无相关性(P>0.05)。结论骨髓瘤患者骨骼疼痛程度与血钙水平及瘤细胞数相关,与免疫分型无关;化疗+膦酸盐+美施康定止痛效果优于单纯化疗。

Objective To analyze the causes of multiple myeloma(MM) pain to find its best remedy.Methods Retrospective analyses were performed on data of 76 MM patients with moderate or severe bone pains,who were divided into 4 groups according to different treatments.The curative effects of 4 groups were compared.Results In group A(n=26),bone pains were completely remitted in 8,partly in 13,no effects in 5;in group B(n=20),completely in 3,partly in 5,no effects in 12;in group C(n=10),completely in 2,partly in 3,no effects in 5;in group D(n=20),completely in 10,partly in 7,no effects in 3,and the difference was significant(P<0.05).Bone pains were positively correlated with oncocyte number and serum calcium level(P<0.05),but not with immunophenotyping(P>0.05).Conclusion Bone pains have correlation with serum calcium level and oncocyte number,but not with immunophenotyping;the effect of chemotherapy plus diphosphonates and MS Contin is superior to chemotherapy alone.