PCD方案联合磷酸氟达拉滨对多发性骨髓瘤患者血清β2-MG LDH及IL-6水平的影响

Effect of PCD regimen combined with fludarabine phosphate on serum levels of beta 2-MG,LDH and IL-6 in multiple myeloma patients

探讨PCD方案联合磷酸氟达拉滨对多发性骨髓瘤患者血清β2微球蛋白、乳酸脱氢酶、白细胞介素-6水平变化的影响.方法 将82例多发性骨髓瘤患者采用随机数字表法分为研究组与对照组,每组各41例.两组均给予PCD方案治疗,研究组在此基础上联合磷酸氟达拉滨治疗,观察3个疗程.比较两组临床疗效、不良反应,比较治疗前后血清β2微球蛋白、乳酸脱氢酶、白细胞介素-6水平,随访24个月,比较两组生存率.结果 研究组治疗总有效率为87 .8%,对照组为68 .3%,研究组显著高于对照组(P<0 .05) .治疗前两组血清β2微球蛋白、乳酸脱氢酶、白细胞介素-6水平比较差异无统计学意义(P> 0 .05) ,治疗后两组均显著低于治疗前(P<0 .01) ,研究组较对照组下降更显著(P<0 .01).两组不良反应发生率比较差异无统计学意义(P>0 .05) ,治疗后12个月两组生存率比较差异无统计学意义(P>0 .05) ,治疗后18个月及24个月研究组生存率均显著高于对照组(P<0 .05) .结论 PCD方案联合磷酸氟达拉滨治疗多发性骨髓瘤患者疗效显著,可有效降低血清β2微球蛋白、乳酸脱氢酶、白细胞介素-6水平,延长患者生存期,安全性高.

Objective To investigate the effect of PCD regimen combined with fludarabine phosphate on serum levels of beta 2-MG ,LDH and IL-6 in multiple myeloma patients .Methods 82 patients with MM were randomly divided into control group and study group ,41 cases in each group .Both groups were given PCD regimen treatment ,and the study group was treated with fludarabine phosphate on this basis ,both groups were observed for 3 courses .The clinical efficacy and adverse reactions of the two groups were compared .The serum levels of beta-2-microglobulin ,lactate dehydrogenase and interleukin-6 were com-pared before and after treatment .The survival rates of the two groups were compared after 24 months fol-low-up .Results The total effective rate was 87 .8% in the study group and 68 .3% in the control group , which was significantly higher in the study group than in the control group (P<0 .05).The levels of ser-um beta-2-microglobulin ,lactate dehydrogenase and interleukin-6 were not significantly different between the two groups before treatment (P> 0 .05).After treatment ,the levels of serum beta-2-microglobulin , lactate dehydrogenase and interleukin-6 in both groups were significantly lower than those before treatment (P<0 .01).The study group decreased more significantly than the control group (P<0 .01).There was no significant difference in the incidence of adverse reactions between the two groups (P>0 .05).There was no significant difference in the survival rate between the two groups at 12 months after treatment (P>0 .05).The survival rates of the study group at 18 and 24 months after treatment were significantly higher than those of the control group (P<0 .05).Conclusion PCD regimen combined with fludarabine phosphate is effective in the treatment of multiple myeloma .It can effectively reduce the levels of serum beta-2 microglobulin ,lactate dehydrogenase and interleukin-6 ,and prolong the survival of patients with high safety.