硼替佐米联合方案治疗多发性骨髓瘤肾病疗效观察

Bortezomib in Combination with Chemotherapy in the Treatment of Multiple Myeloma Nephropathy

目的探讨硼替佐米联合方案治疗多发性骨髓瘤肾病的疗效及安全性。方法选取2014年9月~2016年9月采用化疗方案治疗多发性骨髓瘤肾病患者41例,随机分为观察组和对照组。对照组23例采用常规化疗方案,观察组18例采用硼替佐米联合常规化疗方案。以β2-微球蛋白(β2-MG)、肌酐清除率为观察指标,观察化疗前后肾功能的变化,同时观察原发病缓解情况,记录相关不良反应。结果观察组肾功能改善率(66.7%)明显优于对照组(30.4%);观察组缓解率(83.3%)亦高于对照组(47.8%);观察组消化道反应发生率(27.8%)、骨髓抑制发生率(33.3%)、感染发生率(44.4%)均低于对照组,但观察组周围神经病变的发生率(38.9%)却高于对照组(34.8%)。结论硼替佐米联合方案治疗多发性骨髓瘤肾病患者,可明显改善患者肾功能情况,提高原发病缓解率,减少相关不良反应,其疗效和安全性明显优于常规化疗方案。

Objective To investigate the effec, t and safety of bortezomib combined with chemotherapy in tile treatment of muhiple myeloma palieuts with nephropathy. Methods In this research,41 patients with muhiple myeloma nephropathy treated with chemotherapy from Seplember 2014 to September 2016 in weifang people＇s, hospital ,of whieh 23 cases were treated with conventional chemotherapy （control group） , 18 cases by bortezomib combined with eonventional chemotherapy（observation group）. The beta 2 microglobulin and creatinine clear- ance rate were regarded as observational iudexs of the renal function changes belbre and after chemotherapy. Besides,observed the remission of primm7 disease and recorded related adverse reactions. Results The improvement rate of renal function in the observation group（66.7% ） was signifieantly belier than that of the control group（ 30.4% ） ,and the remission rate of the observation group （ 83.3% ） was higher than that of the control group（ 47.8% ） ;The incidence of gastrointestinal reactions（27.8% ） , the incidence of bone marrow suppression（33.3% ） and infection rate（44.4% ） of the observation group were lower than the conlrol group ,but the observation group of peripheral neuropathy（38. 9% ） was higher than that of the control group（ 34.8% ）. Conclusion Bortezomib combined with chemotherapy in the treatmenl of multiple nlveloma nephropathy patients,can improve renal function in patients with primary disease,improve the remission rate, reduce adverse reac- tion,its efficacy and safety is obviously better than that of conventional chemotherapy.