来那度胺联合硼替佐米治疗多发性骨髓瘤的临床效果及对免疫功能、不良反应的影响

Clinical effect of lenalidomide combined with bortezomib in the treatment of multiple myeloma and its impact on immune function and adverse reactions

目的 观察来那度胺联合硼替佐米治疗多发性骨髓瘤的临床效果及对免疫功能、不良反应的影响。方法 选取2020年2月—2022年5月喀什地区第一人民医院收治的多发性骨髓瘤患者70例,根据随机抽样法分为研究组(n=35)和参照组(n=35)。在常规治疗基础上,参照组予硼替佐米治疗,研究组在参照组基础上加用来那度胺治疗,2组均治疗12周。比较2组治疗前后免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+))、血清炎性因子[C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]水平、视觉模拟评分法(VAS)评分及不良反应。结果 治疗12周后,2组CD3^(+)、CD4^(+)较治疗前升高,CD8^(+)较治疗前降低,且研究组升高/降低幅度大于参照组(P均<0.01);2组血清CRP、IL-6、TNF-α水平及VAS评分均较治疗前降低,且研究组低于参照组(P均<0.01)。研究组不良反应总发生率为11.43%,低于参照组的31.43%(χ^(2)=4.157,P=0.041)。结论 来那度胺联合硼替佐米治疗多发性骨髓瘤可提高患者免疫功能,降低炎性因子水平,减轻疼痛程度,降低不良反应发生率。

Objective To observe the clinical effect of lenalidomide combined with bortezomib in the treatment of multiple myeloma and its impact on immune function and adverse reactions.Methods A total of 70 patients with multiple myeloma admitted to the First People′s Hospital of Kashgar Region from February 2020 to May 2022 were selected and randomly divided into study group(n=35)and reference group(n=35).On the basis of routine treatment,the reference group was treated with bortezomib,while the study group was treated with lenalidomide on the basis of the reference group.Both groups were treated for 12 weeks.Immune function indicators(CD3^(+),CD4^(+),CD8^(+)),serum inflammatory factors(CRP,IL-6,TNF-α),Visual Analog Scale(VAS)scores before and after treatment,and adverse reactions between the two groups were compared.Results After 12 weeks of treatment,CD3^(+)and CD4^(+)in the two groups increased compared to before treatment,while the CD8^(+)decreased compared to before treatment,and the increase or decrease amplitude in the study group was greater than that in the reference group(all P<0.01).The levels of serum CRP,IL-6,TNF-αand VAS scores in the two groups decreased compared to before treatment,and the study group were lower than the reference group(all P<0.01).The total incidence of adverse reactions in the study group was 11.43%,lower than the 31.43%in the reference group(χ^(2)=4.157,P=0.041).Conclusion The combination of lenalidomide and bortezomib can improve patients′immune function in the treatment of multiple myeloma,improve inflammatory factor levels,alleviate pain levels,and reduce the incidence of adverse reactions.