多柔比星脂质体分别联合来那度胺、沙利度胺治疗多发性骨髓瘤临床疗效比较

Comparison of the Clinical Efficacy of Doxorubicin Liposomes Combined with Lenalidomide or Thalidomide in the Treatment of Multiple Myeloma

目的:观察比较多柔比星脂质体分别联合来那度胺、沙利度胺治疗多发性骨髓瘤的临床疗效。方法:100例多发性骨髓瘤患者随机分为对照组和观察组各50例。对照组患者给予多柔比星脂质体注射液联合沙利度胺胶囊治疗,观察组患者给予多柔比星脂质体联合来那度胺胶囊治疗。比较2组患者治疗前后相关指标[骨髓浆细胞、血M蛋白量、骨特异性碱性磷酸酶(BAP)、乳酸脱氢酶(LDH)、护骨素(OPG)]以及凝血功能[血浆D-二聚体、纤维蛋白原(FIB)、抗凝血酶(AT)]的变化,评价两组临床疗效及药品不良反应。结果:治疗后,两组骨髓浆细胞、血M蛋白量、血浆AT水平均较前明显降低,而血清BAP、LDH、OPG、血浆D-二聚体、FIB水平则较前明显升高(P<0.05);且观察组上述各项指标除AT水平外均优于对照组(P<0.05)。对照组治疗总有效率为74.00%,显著低于观察组的92.00%(P<0.05);且观察组药品不良反应发生率明显低于对照组(P<0.05)。结论:与多柔比星脂质体联合沙利度胺相比,多柔比星脂质体联合来那度胺能更有效改善患者凝血功能,缓解病情,更为安全有效。

Objective:To observe and compare the clinical efficacy of doxorubicin liposomes combined with lenalidomide or thalidomide in the treatment of multiple myeloma.Methods:One hundred patients with multiple myeloma were randomly divided into control group and observation group with 50 cases in each group.The control group was given doxorubicin liposomes combined with thalidomide,and the observation group was given doxorubicin liposomes combined with lenalidomide.The related indexes[bone marrow plasma cells,blood M protein,bone-specific alkaline phosphatase(BAP),lactate dehydrogenase(LDH),osteoprotegerin(OPG)],and coagulation function[plasma D-dimer,fibrinogen(FIB),antithrombin(AT)]changes were compared between the two groups before and after treatment.The clinical efficacy and adverse drug reactions of the two groups were evaluated as well.Results:After treatment,the levels of bone marrow plasma cells,blood M protein and AT in the two groups were significantly lower than those before treatment,while the levels of serum BAP,LDH,OPG,plasma D-dimer and FIB were significantly higher than those before treatment(P<0.05).Except AT level,the above indexes in the observation group were better than those in the control group(P<0.05).The total effective rate in the control group was 74.00%,which was significantly lower than that(92.00%)in the observation group(P<0.05);the incidence of adverse drug reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Compared with doxorubicin liposomes combined with thalidomide,doxorubicin liposomes combined with lenalidomide can more effectively improve the coagulation function and relieve the disease of patients,which is safer and more effective.