微生态调节剂对多发性骨髓瘤患者化疗期间营养、炎性、免疫指标及并发症等影响

Effects of Microecological Modulators on Nutrition,Inflammation,Immune Indexes and Complications in Patients with Multiple Myeloma during Chemotherapy

目的探讨微生态调节剂对多发性骨髓瘤(MM)患者化疗期间营养、炎性、免疫指标及并发症等影响。方法选取2018年1-12月收治的分型为IgA或IgG的初治MM 80例,根据化疗期间是否采用微生态调节剂将其分为观察组(38例)和对照组(42例)两组。观察组化疗期间采用微生态调节剂,对照组化疗期间未采用微生态调节剂。观察比较两组化疗前1 d和化疗第6、13天营养、炎性和免疫指标,治疗期间并发症发生情况,以及患者满意度。结果两组组内血白蛋白、血红蛋白、白细胞、CD4+和CD4+/CD8+经重复测量设计方差分析不同时间点总体比较差异有统计学意义(P<0.01)。对照组化疗第13天血白蛋白和血红蛋白均较化疗前1 d降低,观察组化疗第6天和两组化疗第13天血白细胞较化疗前1 d下降,观察组化疗第6天和化疗第13天CD4+较化疗前1 d升高,观察组化疗第6天和两组化疗第13天CD4+/CD8+较化疗前1 d升高,差异有统计学意义(P<0.05或P<0.01)。血白蛋白、血红蛋白、白细胞、C反应蛋白、CD3+、CD4+和CD4+/CD8+,两组组别与时间点均无交互作用(P>0.05);两组组间比较差异均无统计学意义(P>0.05)。治疗期间,观察组腹泻、便秘和食欲缺乏发生率均低于对照组,差异有统计学意义(P<0.05)。观察组患者满意度高于对照组,差异有统计学意义(P<0.05)。结论微生态调节剂可改善MM化疗患者血白蛋白、白细胞和T淋巴细胞等,降低腹泻、便秘和食欲缺乏发生率。

Objective To investigate effects of microecological modulators on nutrition,inflammation,immunity indexes and complications in patients with multiple myeloma(MM)during chemotherapy.Methods A total of 80 patients initially treated for MM who were classified as IgA or IgG from January to December 2018 were selected,and the patients were divided into observation group(n=38)and control group(n=42)according to the application of microecological modulators during chemotherapy.Observation group was given microecological modulators during chemotherapy,while control group was not given.Nutrition,inflammation,immunity indexes on the 1 st d before chemotherapy and on the 6 th and 13 th d after chemotherapy,incidence rates of complications during treatment and patients'satisfaction were observed and compared between two groups.Results Levels of albumin(ALB),hemoglobin(HGB),white blood cell(WBC)count,CD4+and CD4+/CD8+in the two groups were compared by repeated measures design analysis of variance,and the differences were statistically significant at different time points in each group(P<0.01).Levels of plasma ALB and HGB on the 13 th d after chemotherapy were significantly lower than those on the 1 st d before chemotherapy in control group;WBC levels were significantly lower in observation group on the 6 th d after chemotherapy and in both groups on the 13 th d after chemotherapy were respectively compared with those on the 1 st d before chemotherapy in observation group and in both groups;CD4+levels on the 6 th and 13 th d after chemotherapy were significantly higher than that on the 1 st d before chemotherapy in observation group;CD4+/CD8+levels in observation group on the 6 th d after chemotherapy and in both groups on the 13 th d after chemotherapy were significantly higher than those on the 1 st d before chemotherapy in observation group and in both groups respectively(P<0.05 or P<0.01).No significant differences in interaction were found among time points and groups with respect to plasma levels of ALB,HGB,WBC,C-reactive protein,CD3+,CD4+and CD4+/CD8+(P>0.05).There were no statistically significant differences in interaction between groups(P>0.05).Incidence rates of diarrhea,constipation and loss of appetite during treatment in observation group were significantly lower than those in control group(P<0.05).In addition,patients'satisfaction in observation group was significantly better than that in control group(P<0.05).Conclusion Microecological modulators may improve plasma ALB,WBC and T lymphocytes,and reduce incidence rates of diarrhea,constipation and loss of appetite in patients with MM.