硼替佐米、来那度胺、地塞米松联合应用于初诊多发性骨髓瘤患者临床治疗中的效果分析

Effectiveness of the Combination of Bortezomib,Lenalidomide,and Dexamethasone in the Clinical Treatment of Patients with Primary Diagnosis of Multiple Myeloma

目的探讨联用硼替佐米、来那度胺及地塞米松在初诊多发性骨髓瘤(Multiple Myeloma,MM)中的疗效。方法方便选取黔西南州人民医院于2019年11月—2023年11月收治的68例初诊MM患者为研究对象,经随机数表法分为两组,各34例。对照组行硼替佐米联合地塞米松治疗,观察组在对照组基础上加用来那度胺治疗。比较两组临床疗效、血清生化指标、生存质量及不良反应发生率。结果观察组总有效率为94.12%,高于对照组的76.47%,差异有统计学意义(χ^(2)=4.221,P=0.040);治疗后,观察组M蛋白、骨髓浆细胞为(22.32±2.11)g/L、(15.41±1.56)%,低于对照组的(27.65±2.37)g/L、(21.41±2.85)%,差异有统计学意义(t=9.794、10.768,P均<0.05);观察组生存质量评分高于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论联用硼替佐米、来那度胺及地塞米松可提高初诊MM患者疗效,降低M蛋白、骨髓浆细胞水平,提高生活质量,安全可行。

Objective To explore the efficacy of the combination of bortezomib,lenalidomide and dexamethasone in the primary diagnosis of multiple myeloma(MM).Methods A total of 68 patients with primary diagnosis of MM admitted to Qianxinan Prefecture People's Hospital from November 2019 to November 2023 were conveniently selected as study objects and divided into two groups by random number table method,with 34 cases in each group.The control group was treated with bortezomib combined with dexamethasone,and the observation group was treated with lenalidomide on the basis of the control group.The clinical efficacy,serum biochemical indexes,survival quality and the incidence of adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 94.12%,which was higher than that of the control group 76.47%,and the difference was statistically significant(χ^(2)=4.221,P=0.040).The M protein and bone marrow plasma cells of the observation group were(22.32±2.11)g/L and(15.41±1.56)%,which were lower than those of the control group(27.65±2.37)g/L,(21.41±2.85)%,and the differences were statistically significant(both P<0.05).The score of quality of survival in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions were compared between the two groups,and the difference were not statistically significant(P>0.05).Conclusion The combination of bortezomib,lenalidomide and dexamethasone can improve the efficacy of patients with first diagnosis of MM,reduce the level of M protein and bone marrow plasma cells,and improve the quality of life,which is safe and feasible.