摘要
目的:分析PCD方案治疗多发性骨髓瘤(multiple myeloma,MM)的疗效及预后,并探讨其与血清抗酒石酸酸性磷酸酶5b(TRACP-5b)、RhoA及维生素D3(Vitamin D3)的关系。方法:选取2013年3月至2016年3月于恩施土家族苗族自治州中心医院血液内科收治的64例MM患者作为研究对象,根据是否合并骨性病变将其分为骨髓瘤骨病(MBD)组和无骨髓瘤骨病(N-MBD)组,分别有40例和24例。所有研究对象均给予PCD方案治疗(硼替佐米+环磷酰胺+地塞米松),并采用酶联免疫吸附试验(ELISA)检测治疗前后各组血清TRACP-5b、RhoA和Vitamin D3水平。对比两组疗效和预后差异,并分析其与血清TRACP-5b、RhoA和Vitamin D3的关系。结果:与MBD组比较,N-MBD组临床疗效改善明显,其总有效率相对升高,差异有统计学意义(P<0.05);64例MM患者中,40例治疗有效,24例治疗无效;治疗前后,与无效组比较,有效组血清TRACP-5b、Rho A和Vitamin D3水平均相对减少,差异均有统计学意义(P<0.05);且有效组治疗前-治疗后下降程度大于无效组,差异有统计学意义(P<0.05)。MBD组和N-MBD组治疗后不良反应总发生率比较,差异无统计学意义(P>0.05)。随访截止,绘制Kaplan-Meier生存曲线分析发现:与MBD组比较,NMBD组PFS生存率和OS生存率升高,差异均有统计学意义(P=0.013,P=0.013);64例MM患者中,27例生存,37例死亡;生存组治疗前血清TRACP-5b、Rho A和Vitamin D3水平明显低于死亡组,差异均有统计学意义(P<0.05)。结论:与骨髓瘤骨病患者比较,PCD方案治疗无骨髓瘤骨病患者疗效和预后更好,与血清TRACP-5b、Rho A和Vitamin D3水平有关。
Objective:To analyze the efficacy and prognosis of PCD regimen treating multiple myeloma(MM),and to explore its relationship with serum tartrate-resistant acid phosphatase 5 b(TRACP-5 b),RhoA and Vitamin D3.Methods:64 MM patients admitted to the department of hematology of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March 2013 to March 2016 were selected as the research objects.According to whether they were combined with osteopathy,they were divided into bone marrow tumor osteopathy(MBD)group and none bone marrow tumor osteopathy(N-MBD)group,with 40 cases and 24 cases respectively.All subjects were treated with PCD regimen(bortezomib+cyclophosphamide+dexamethasone),and the levels of serum TRACP-5 b,RhoA and Vitamin D3 in two groups were detected by enzyme-linked immunosorbent assay(ELISA).Results:Compared with the MBD group,the clinical effect of N-MBD group improved significantly,and the total effective rate of N-MBD group increased relatively,and the difference was statistically significant(P<0.05).Among 64 MM patients,40 cases were effective and 24 cases were ineffective.Before and after treatment,compared with the ineffective group,and the serum TRACP-5 b,RhoA and Vitamin D3 in the effective group were relatively reduced,the difference was statistically significant(P<0.05).But before-after treatment,the degree of decline in the effective group was greater than that in the ineffective group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between MBD group and N-MBD group(P>0.05).By the end of follow-up,Kaplan Meier survival curve analysis showed that compared with MBD group,the PFS survival rate and OS survival rate of N-MBD group were significantly higher(P=0.013,P=0.013).Among 64 MM patients,27 survived and 37 died.The levels of serum TRACP-5 b,RhoA and Vitamin D3 in survival group were significantly lower than those in death group before treatment(P<0.05).Conclusion:Compared with patients wi
作者
许京淑
向航
邹禄平
向金平
Xu Jingshu;Xiang Hang;Zou Luping;Xiang Jinping(Department of Hematology,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Hubei Enshi 445000,China)
出处
《现代肿瘤医学》
CAS
2020年第18期3231-3235,共5页
Journal of Modern Oncology
基金
湖北省自然科学基金科研项目(编号:2012FFB05906)。
