不同剂量帕米膦酸二钠治疗肿瘤骨转移的疗效观察

Observation on curative effect of different doses of Pamidronate disodium treatment in osseous metastasis

目的探讨不同剂量帕米膦酸二钠治疗肿瘤骨转移的疗效及安全性。方法采用随机对照观察，对120例确诊为骨转移肿瘤并伴骨痛的患者随机分为3组（A、B、C），每组各40例；A组采用采用帕米膦酸二钠45mg／次，静脉滴注，共2次；B组采用帕米膦酸二钠60mg／次，静脉滴注，共2次；C组采用帕米膦酸二钠90mg／次，静脉滴注，共2次；3组均每4周重复，共2周期；3组帕米膦酸二钠均加入0．9％的氯化钠注射液500mL静脉滴注4～6h。结果大剂量帕米膦酸二钠对晚期肿瘤骨转移者在止痛、改善生活质量及活动能力3方面均优于常规剂量组（P〈0．01）；与中剂量组比较，在止痛效果、活动能力改善上差异具有统计学意义（P〈o．05）；中剂量组与常规剂量组比较其优势仅体现在止痛效果上差异有统计学意义（P〈0．05），而在其他几方面差异无统计学意义。3个剂量组均无近期严重不良反应发生。结论大剂量帕米膦酸二钠在止痛、改善患者生活质量、活动能力方面疗效好，值得临床进一步推广使用。

Objective To assess the efficacy and safety of different doses of pamidronate disodium in patients with osseous metastasis. Methods The study followed a randomized controlled design. A total cases of 120 patients with osseous metastasis were randomized into three groups（A,B,C）,40 cases in each group. The patients separately received 45 mg, 60 mg and 90 mg pamidronate disodium as a 4-6 hrs intravenous infusion twice a day every 4 weeks. Results The effects of large dose of pamidronate diso dium in relieving bone pain and improving quality of life as well as locomotor activity were better compared with the conventional dose group（P〈0.01） and the moderate dose group（P〈0.05） ,but there was only statistical difference in analgesic effect between the conventional dose group and the moderate dose group（P〈0.05）. There was no severe adverse effect in all the groups. Conclusion High-dose pamidronate disodium is effective in relieving bone pain in patients with metastatic bone cacer and improving quali ty of life as well as locomotor activity,which deserves further spread in clinical work.