硼替佐米+地塞米松联合血液透析治疗多发性骨髓瘤肾病的临床研究

Clinical Study on Treatment of Multiple Myeloma Nephropathy with VD regimen(Bortezomib Dexamethasone) Combined with Hemodialysis

目的:研究硼替佐米+地塞米松(VD方案)联合血液透析(HD)治疗多发性骨髓瘤肾病的临床效果,旨在为更好地治疗多发性骨髓瘤肾病患者提供有效的理论依据。方法:回顾性分析2016年1月至2018年1月我院收治的40例多发性骨髓瘤肾病患者的临床资料,按不同治疗方法将其分成对照组和研究组(每组20例)。对照组给予VD方案治疗,研究组在对照组的基础上联合血液透析(HD)治疗。观察并比较两组患者临床疗效、血清肌酐、血钙、血尿酸、血清免疫球蛋白、轻链蛋白定量水平以及不良反应的具体情况。结果:研究组患者治疗后临床总有效率显著高于对照组(95.00%vs 70.00%)(P<0.05);治疗后,研究组与对照组血清肌酐、血钙、血尿酸等指标水平均较治疗前明显降低,且研究组各指标降低程度大于对照组(P<0.05);治疗后,两组血清免疫球蛋白水平与治疗前比较明显下降(P<0.05),研究组轻链蛋白定量水平降低程度大于对照组(P<0.05);对照组不良反应发生率高于研究组(30.00%vs 5.00%)(P<0.05)。结论:VD方案联合HD对多发性骨髓瘤肾病患者具有良好的临床疗效,能明显改善多发性骨髓瘤肾病患者临床症状以及相关指标水平,且安全性高。

Objective: To study the clinical effect of VD regimen (bortezomib dexamethasone) combined with hemodialysis (HD) in the treatment of multiple myeloma nephropathy in order to provide effective theoretical basis for better treatment of multiple myeloma nephropathy.Methods: 40 patients with multiple myeloma nephropathy treated in our hospital from January 2016 to January 2018 were retrospectively analyzed and divided into two groups according to different treatment,the control group and study group (with 20 cases in each group).Methods: The control group was treated with VD regimen,and the study group was treated with (HD) combined with hemodialysis on the basis of the control group.The clinical therapy effect,serum creatinine,serum calcium,serum uric acid,serum immunoglobulin,light chain protein levels and adverse reactions in two groups were compared.Results: The total effective rate after treatment in the study group was significantly higher than that in the control group (95.0% vs 70.00%)(P<0.05).After treatment,the levels of serum creatinine,serum calcium and uric acid in the study group and the control group were significantly lower than those before the treatment,and the degree of decrease in each index in the study group was greater than that in the control group (P<0.05). After treatment,the level of serum immunoglobulin in the two groups was significantly lower than that before treatment (P<0.05),and the quantitative level of light chain protein in the study group was significantly lower than that before treatment.The incidence of adverse reactions in the control group was higher than that in the study group (30.00% vs 5.00%)(P<0.05).Conclusion: VD regimen combined with HD has a good clinical effect on patients with multiple myeloma nephropathy.It can obviously improve the clinical symptoms and related indexes of the patients with multiple myeloma nephropathy.And the safety is high,so it is worth popularizing and applying further.