伐昔洛韦预防多发性骨髓瘤并发带状疱疹的有效性及对患者血清IFN-γ、IL-6水平的影响

Efficacy of valaciclovir preventive treatment in multiple myeloma complicated with herpes zoster and the effect of this treatment on serum IFN-γand IL-6 level

目的:探讨伐昔洛韦预防多发性骨髓瘤并发带状疱疹的疗效及对患者血清IFN-γ和IL-6水平的影响。方法:将100例我院收治的多发性骨髓瘤患者随机分为观察组及对照组。两组患者均接受PAD化疗方案,观察组患者在此基础上口服盐酸伐昔洛韦片。比较两组患者治疗后的疗效、带状疱疹发生率及不良反应发生情况;比较两组患者治疗前及治疗后血清IFN-γ、IL-6及T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))水平。结果:两组患者总有效率相比较无统计学差异(P>0.05);观察组患者带状疱疹发生率(2.0%)低于对照组患者(20.0%)(P<0.01);观察组患者恶心呕吐及乏力发生率均高于对照组患者(P<0.05);治疗后,观察组患者血清IFN-γ水平高于对照组患者(P<0.01),IL-6水平低于对照组患者(P<0.01);治疗后,观察组患者血液CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均高于对照组患者(P<0.01),CD8^(+)水平低于对照组患者(P<0.01)。结论:伐昔洛韦能够有效预防多发性骨髓瘤患者化疗期间带状疱疹的发生,不影响化疗的疗效,同时安全性较高,并能够调节IFN-γ、IL-6及T淋巴细胞亚群的水平。

Objective:To explore the efficacy of valaciclovir preventive treatment in multiple myeloma complicated with herpes zoster and the effect of this treatment on serum IFN-γ and IL-6 level.Methods:100 patients with multiple myeloma in our hospital were randomly divided into the observation group and the control group.Patients in both groups were received PAD chemotherapy,and patients in the observation group were received valaciclovir hydrochloride tablets on this basis.The efficacy,incidence of herpes zoster and adverse reactions were compared between the two groups.Serum level of IFN-γ,IL-6 and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+))before and after treatment was compared between the two groups.Results:The difference of total effective rate between the two groups was not statistically significant(P>0.05).The incidence of herpes zoster in the observation group(2.0%)was lower than that in the control group(20.0%)(P<0.01).The incidence of nausea,vomiting and fatigue in the observation group was higher than that in the control group(P<0.05).After treatment,the serum level of IFN-γ in the observation group was higher than those in the control group(P<0.01),and the IL-6 level was lower than those in the control group(P<0.01).After treatment,the blood CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)level in the observation group was higher than those in the control group(P<0.01),and CD8^(+)level was lower than those in the control group(P<0.01).Conclusion:Valaciclovir can effectively prevent the occurrence of herpes zoster during chemotherapy in patients with multiple myeloma.At the same time,it has high safety and can regulate the level of IFN-γ,IL-6 and T lymphocyte subsets.