硼替佐米和沙利度胺治疗对多发性骨髓瘤患者外周血T细胞亚群及相关细胞因子的影响

Effects of bortezomib and thalidomide on T lymphocyte subsets and related cytokines in peripheral blood of patients with multiple myeloma

目的探讨分析硼替佐米和沙利度胺治疗对多发性骨髓瘤(MM)患者外周血T细胞亚群及相关细胞因子的影响。方法选择2016年3月-2018年3月本院收治的初发MM患者78例,随机分为硼替佐米组40例、沙利度胺组38例,再选择50例健康志愿者作为对照组。硼替佐米组患者给予硼替佐米联合地塞米松治疗,沙利度胺组患者给予沙利度胺、长春新碱、表柔比星联合地塞米松治疗。比较2组治疗疗效,检测2组MM患者治疗前后及对照组外周血Th17、Treg细胞比例以及IL-6、IL-17、TGF-β水平。结果2组MM患者治疗后Treg显著升高(P<0.05),Th17细胞比例显著降低(P<0.05),且硼替佐米组改善程度更优(P<0.05)。2组MM患者治疗后血清IL-6、IL-17以及TGF-β水平较治疗前显著降低(P<0.05),且治疗后硼替佐米组血清IL-6、IL-17以及TGF-β水平显著低于沙利度胺组(P<0.05)。结论硼替佐米和沙利度胺治疗多发性骨髓瘤均具有一定的疗效,可有效改善机体Treg、Th17细胞比例,降低血清IL-6、IL-17以及TGF-β细胞因子表达,且以硼替佐米联合地塞米松治疗方案效果更佳。

Objective To investigate the effects of bortezomib and thalidomide on T cell subsets and related cytokines in peripheral blood of patients with multiple myeloma.Methods A total of 78 patients with MM from March 2016 to March 2018 were randomly divided into bortezomib group(40 cases)and thalidomide group(38 cases),and 50 healthy volunteers were selected as control group.Bortezomib group was treated with bortezomib combined with dexamethasone,while thalidomide group was treated with thalidomide,vincristine and epirubicin combined with dexamethasone.The therapeutic effects of the two groups were compared,and the ratio of Th17 and Treg cells in peripheral blood and the levels of IL-6,IL-17 and TGF-β in the two groups before and after treatment and in the control group were detected.Results Treg increased significantly after treatment(P<0.05)and Th17 cells decreased significantly(P<0.05)in MM patients of both groups,and the improvement of Bortezomib group was better(P<0.05).Serum levels of IL-6,IL-17 and TGF-βin MM patients in both groups were significantly lower than those before treatment(P<0.05),and serum levels of IL-6,IL-17 and TGF-β in bortezomib group were significantly lower than thalidomide group(P<0.05).Conclusion Bortezomib and thalidomide are effective in the treatment of multiple myeloma,which can effectively improve the proportion of Treg and Th17 cells,reduce the expression of serum IL-6,IL-17 and TGF-β cytokines,and the combination of bortezomib and dexamethasone is more effective.