VTD方案治疗多发性骨髓瘤效果分析及对患者骨代谢、免疫功能的影响

Clinical Efficacy of VTD Regimen in Treatment of Patients with Multiple Myeloma and Its Effects on Bone Metabolism and Immune Function

目的分析VTD方案治疗多发性骨髓瘤效果及对患者骨代谢、免疫功能的影响。方法选取2016年2月—2021年1月我院92例多发性骨髓瘤,按治疗方式分为研究组47例和对照组45例。研究组予VTD方案治疗,对照组予VD方案治疗。比较2组疗效,治疗前后骨代谢因子[碱性磷酸酶(ALP)、骨钙素(BGP)、总Ⅰ型前胶原氨基端延长肽(TPINP)]及免疫功能指标(CD3+、CD4+、CD8+及CD4+/CD8+)和不良反应。结果研究组总有效率明显高于对照组(P<0.01)。治疗后2组ALP、BGP、CD3+、CD4+及CD4+/CD8+上升,TPINP、CD8+下降,其中以研究组变化最为显著(P<0.05,P<0.01)。2组不良反应总发生率比较无显著差异(P>0.05)。结论VTD方案治疗多发性骨髓瘤效果确切,可恢复溶骨与成骨均衡状态,调节机体免疫功能,且不会增加不良反应。

Objective To analyze clinical efficacy of VTD regimen in treatment of patients with multiple myeloma and its effects on bone metabolism and immune function.Methods A total of 92 patients with multiple myeloma between February 2016 and January 2021 were selected and divided into research group(n=47)and control group(n=45)according to different therapeutic methods.Research group was treated with VTD regimen,while control group was treated with VD regimen.Clinical efficacy,bone metabolic factors[alkaline phosphatase(ALP),osteocalcin(BGP),total type I procollagen amino terminal elongation peptide(TPINP)]and immune function indexes(CD3+,CD4+,CD8+and CD4+/CD8+)and adverse reactions were compared before and after treatment between two groups.Results The total effective rate in research group was significantly higher than that in control group(P<0.01).After treatment,levels of ALP,BGP,CD3+,CD4+and CD4+/CD8+were significantly increased,while levels of TPINP and CD8+were significantly decreased in two groups,and the changes were more obvious in research group(P<0.05,P<0.01).There was no significant difference in total incidence rate of adverse reactions between two groups(P>0.05).Conclusion VTD regimen is effective in treatment of patients with multiple myeloma.It may restore the balance between osteolysis and osteogenesis and regulate immune function without increasing adverse reactions.