硼替佐米、环磷酰胺和地塞米松治疗多发性骨髓瘤的效果

Effect of Bortezomib,Cyclophosphamide and Dexamethasone Regimen on Multiple Myeloma

目的分析硼替佐米、环磷酰胺和地塞米松方案(BCD方案)治疗多发性骨髓瘤(MM)患者的效果。方法选取河南科技大学第一附属医院2019年3月至2021年1月收治的86例MM患者作为研究对象,采用随机数字表法分为对照组和观察组,各43例。对照组接受长春新碱、多柔比星和地塞米松方案(VAD方案)治疗,观察组接受BCD方案治疗,持续治疗21 d为1周期,两组均治疗4个周期。比较两组治疗4个周期时疾病缓解情况。比较两组治疗前、治疗4个周期时的免疫功能及骨代谢情况。比较两组治疗期间不良反应发生率。结果治疗4个周期,观察组疾病总缓解率高于对照组(P<0.05)。治疗4个周期,两组CD3^(+)、CD4^(+)值均较治疗前升高,且观察组较对照组高;两组CD8+值均较治疗前降低,且观察组较对照组低(P<0.05)。治疗4个周期,两组血清碱性磷酸酶、Ⅰ型胶原C末端肽水平均较治疗前升高,且观察组较对照组高(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论BCD化疗方案可改善MM患者免疫功能及骨代谢情况,提高疾病缓解率,疗效确切。

Objective To analyze the effect of bortezomib,cyclophosphamide and dexamethasone regimen(BCD regimen)in the treatment of patients with multiple myeloma(MM).Methods A total of 86 patients with MM who were admitted to the First Affiliated Hospital of Henan University of Science and Technology from March 2019 to January 2021 were selected as the research objects.They were randomly divided into the control group and the observation group with 43 patients in each group.The control group received vincristine,doxorubicin and dexamethasone regimen(VAD regimen),and the observation group received BCD regimen.The continuous treatment for 21 days was one cycle,and both groups received four cycles.The disease remission was compared between the two groups after 4 cycles of treatment.The immune function and bone metabolism of the two groups were compared before and after 4 cycles of treatment.The incidence of adverse reactions during treatment was compared between the two groups.Results After 4 cycles of treatment,the total remission rate of the observation group was higher than that of the control group(P<0.05).After 4 cycles of treatment,the values of CD3+and CD4+in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group.The value of CD8^(+)in both groups was lower than that before treatment,and that in the observation group was lower than that in the control group(P<0.05).After 4 cycles of treatment,the levels of serum alkaline phosphatase and C-terminal peptide of type I collagen in both groups were higher than those before treatment,and the levels in the observation group were higher than those in the control group(P<0.05).During the treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion BCD chemotherapy regimen can improve the immune function and bone metabolism of MM patients,and improve the remission rate of the disease,with definite efficacy.