不同化疗方案对多发性骨髓瘤患者凝血功能的影响

Effects of different chemotherapy regimens on coagulation function in patients with multiple myeloma

目的探讨不同化疗方案对多发性骨髓瘤(MM)患者凝血功能的影响。方法选择2017年4月至2019年5月我院收治的多发性骨髓瘤患者90例,采用随机数字表法分为三组,各30例。A组采用VD方案,B组采用VTD方案,C组采用TD方案。比较三组治疗效果及安全性,分别于治疗前、治疗1、2个周期后,比较三组血小板(PLT)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fg)]。结果B组治疗有效率(80.00%)高于A组(50.00%)、C组(53.33%),差异有统计学意义(P<0.05);三组治疗前PLT、TT、PT、APTT比较,差异无统计学意义(P>0.05);三组第1、2周期治疗后患者的TT、PT、APTT、Fg无明显变化,差异无统计学意义(P>0.05)。而PLT呈现明显下降趋势,差异有统计学意义。且A组>B、C组,差异无统计学意义(P<0.05)。三组不良反应发生率对比,差异无统计学意义(P>0.05)。结论VTD方案治疗MM效果最好,三种不同化疗方案对其他凝血功能无明显影响,但VD方案会使血小板降低明显,不会引发严重不良反应,安全性尚可。

Objective To investigate the effects of different chemotherapy regimens on coagulation function in patients with multiple myeloma(MM).Methods A total of 90 patients with multiple myeloma admitted to our hospital from April 2017 to May 2019 were divided into three groups with 30 patients in each group by random number table method.Group A adopted VD scheme,Group B adopted VTD scheme,and Group C adopted TD scheme.The efficacy and safety of the three groups were compared.Platelet(PLT),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fg)were compared between the three groups before treatment,1 and 2 cycles after treatment,respectively.Results The effective rate of group B(80.00%)was higher than that of group A(50.00%)and group C(53.33%),and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in PLT,TT,PT and APTT among the three groups(P>0.05).There were no significant changes in TT,PT,APTT and Fg after the first and second cycles of treatment in the three groups,and the differences were not statistically significant(P>0.05).PLT showed a significant downward trend,and the difference was statistically significant.There was no significant difference in>between group A and group B and C(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion The VTD regimen has the best effect on MM,and the three different chemotherapy regimens have no obvious effect on other coagulation functions.However,the VD regimen can significantly reduce platelet,without causing serious adverse reactions,and its safety is acceptable.