硼替佐米联合沙利度胺与地塞米松治疗多发性骨髓瘤患者的效果

Effects of Bortezomib combined with Thalidomide and Dexamethasone in treatment of patients with multiple myeloma

目的:观察硼替佐米联合沙利度胺与地塞米松治疗多发性骨髓瘤(MM)患者的效果。方法:选取64例MM患者为研究对象,按照随机数字表法分为对照组和观察组各32例。对照组采用环磷酰胺、沙利度胺联合地塞米松(CTD方案)治疗,观察组采用硼替佐米联合沙利度胺与地塞米松(VCD方案)治疗,比较两组近期疗效、免疫功能指标[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、调节性T细胞(Treg)]水平、血液指标(骨髓单克隆浆细胞比例、M蛋白)水平、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平及不良反应发生率。结果:观察组深缓解率为62.50%、总缓解率为87.50%,明显高于对照组的43.75%、59.38%,差异均有统计学意义(P<0.05);观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、Treg水平均明显高于对照组,CRP水平、TNF-α水平、骨髓单克隆浆细胞比例、M蛋白水平均明显低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为28.13%(9/32),明显低于对照组的56.25%(18/32),差异有统计学意义(P<0.05)。结论:硼替佐米联合沙利度胺与地塞米松治疗MM患者的效果优于常规CTD化疗方案,能有效降低骨髓单克隆浆细胞比例和M蛋白水平,减轻机体炎症反应,调节免疫功能,且安全性较好。

Objective:To observe effects of Bortezomib combined with Thalidomide and Dexamethasone in treatment of patients with multiple myeloma(MM).Methods:64 MM patients were selected as the research objects,and were divided into control group and observation group according to the random number table method,each with 32 cases.The control group was treated with Cyclophosphamide,Thalidomide and Dexamethasone(CTD regimen),while the observation group was treated with Bortezomib combined with Thalidomide and Dexamethasone(VCD regimen).The short-term curative effects,the immune function index levels[CD3^(+),CD4^(+),CD4^(+)/CD8^(+),regulatory T cells(Treg)],the blood index levels(bone marrow monoclonal plasma cells,M protein),the inflammatory factor levels[C reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and incidence of adverse reactions were compared between the two groups.Results:The deep remission rate of the observation group was 62.50%,the total remission rate was 87.50%,which were significantly higher than the control group of 43.75%and 59.38%,and the differences were statistically significant(P<0.05).After the treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and Treg in the observation group were significantly higher than those in the control group;the CRP,TNF-α,bone marrow monoclonal plasma cells,and M protein levels were significantly lower than those in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was 28.13%(9/32),which was significantly lower than 56.25%(18/32)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Bortezomib combined with Thalidomide and Dexamethasone in the treatment of the MM patients is superior to conventional CTD chemotherapy.It can effectively reduce the ratio of bone marrow monoclonal plasma cells and the M protein level,reduce the body’s inflammatory response,regulate the immune function,and has good safety.