硼替佐米联合来那度胺及地塞米松(VRD)方案和硼替佐米联合沙利度胺及地塞米松(VTD)方案治疗多发性骨髓瘤的临床疗效

Clinical Efficacy of Bortezomib Combined with Lenalidomide and Dexamethasone(VRD)Regimen and Bortezomib Combined with Thalid omide and Dexamethasone(VTD)Regimen in the Treatment of Multiple Myeloma

目的对比硼替佐米联合来那度胺及地塞米松方案(VRD)和硼替佐米联合沙利度胺及地塞米松方案(VTD)治疗多发性骨髓瘤的临床疗效。方法选取南京市溧水区人民医院(东南大学附属南京中大医院溧水分院)与常熟市第一人民医院(苏州大学附属常熟医院)2018年10月—2021年3月收治的82例多发性骨髓瘤患者,按照随机数字表法分为两组,一组接受VRD方案治疗视作VRD组,一组接受VTD方案治疗视作VTD组,比较两组效果。结果VRD组治疗结束后骨髓浆细胞比例、β_(2)-微球蛋白、乳酸脱氢酶均低于VTD组,血清白蛋白水平高于VTD组,差异有统计学意义(t=10.156、7.175、2.241、10.617,P<0.05)。VRD组治疗结束后SCr、BUN均低于VTD组,差异有统计学意义(t=32.500、8.849,P<0.05)。VRD组治疗后IgA、IgG、IgM均低于VTD组,差异有统计学意义(P<0.05)。VRD组治疗后免疫固定电泳结果转阴率92.86%,明显高于VTD组转阴率77.50%,差异有统计学意义(P<0.05)。VRD组治疗期间不良反应发生率为9.52%,与VTD组12.50%对比,差异无统计学意义(χ^(2)=0.006,P>0.05)。结论多发性骨髓瘤治疗中VRD方案能更明显改善肾功能、免疫球蛋白水平,提高免疫固定电泳转阴率,且治疗安全性良好,临床疗效更好。

Objective To compare the clinical efficacy of bortezomib combined with lenalidomide and dexamethasone(VRD)and bortezomib combined with thalidomide and dexamethasone(VTD)in the treatment of multiple myeloma.Methods A total of 82 patients with multiple myeloma were selected from Nanjing Lishui People's Hospital(Nanjing Zhongda Hospital Lishui Hospital Lishui Branch,Southeast University)and Changshu No.1 People's Hospital(Changshu Hospital Affiliated to Soochow University)from October 2018 to March 2021.According to the random number table method,they were divided into two groups.One group received VRD treatment as the VRD group,and the other group received VTD treatment as the VTD group.Compared the effects of the two groups.Results The ratio of bone marrow plasma cells,β_(2)-microglobulin,and lactate dehydrogenase in the VRD group were lower than those in the VTD group after treatment.The serum albumin level was higher than that of the VTD group,the difference was statistically significant(t=10.156,7.175,2.241,10.617,P<0.05).SCr and BUN in VRD group were lower than those in VTD group after treatment,the difference was statistically significant(t=32.500,8.849,P<0.05).IgA,IgG,and IgM in VRD group were lower than those in VTD group after treatment,the difference was statistically significant(P<0.05).After treatment,the negative rate of immunofixation electrophoresis in the VRD group was 92.86%,which was significantly higher than the negative rate of 77.50%in the VTD group,the difference was statistically significant(P<0.05).The incidence of adverse reactions during treatment in the VRD group was 9.52%,which was not significantly different from 12.50%in the VTD group,the difference was not statistically significant(χ^(2)=0.006,P>0.05).Conclusion VRD regimen in the treatment of multiple myeloma can significantly improve renal function,immunoglobulin levels,and increase the negative rate of immunofixation electrophoresis.And the treatment safety is good,and the clinical efficacy is better.