摘要
目的探讨硼替佐米联合地塞米松(BD)治疗老年多发性骨髓瘤(MM)的临床效果。方法回顾性选取2012年2月~2020年2月山东大学齐鲁医院及甘肃省人民医院收治的100例老年MM患者作为研究对象,按照不同治疗方案分为BD组(50例)与TD组(50例),BD组采用硼替佐米联合地塞米松方案治疗,TD组采用沙利度胺联合地塞米松方案治疗。比较两组患者的临床疗效、不良反应发生情况及生存情况。结果BD组的总有效率及初治患者的有效率高于TD组,差异有统计学意义(P<0.05)。BD组的血红蛋白增长值、血清肌酐下降值、血β2微球蛋白下降值及骨髓中浆细胞比例下降值高于TD组,差异有统计学意义(P<0.05)。随访4~50个月,BD组的生存时间及生存率高于TD组,差异有统计学意义(P<0.05)。BD组乏力、周围神经病变和骨髓抑制的发生率高于TD组,便秘、皮疹、嗜睡、头晕、深静脉血栓的发生率低于TD组,差异有统计学意义(P<0.05)。两组腹痛、腹泻及带状疱疹的发生率比较,差异无统计学意义(P>0.05)。结论对老年MM患者采用BD方案疗效显著,且安全性较高,值得临床推广。
Objective To investigate the clinical effect of Bortezomib combined with Dexamethasone(BD)in the treatment of senile multiple myeloma(MM).Methods A total of 100 elderly patients with MM who were admitted to Qilu Hospital of Shandong University and Gansu People′s Hospital from February 2012 to February 2020 were retrospectively selected as the research objects.According to different treatment regimen,they were divided into BD group(50 cases)and TD group(50 cases).The BD group was treated with Bortezomib combined with Dexamethasone regimen,while the TD group was treated with Thalidomide combined with Dexamethasone regimen.The clinical efficacy,the incidence of adverse reactions and the survival of two groups were compared.Results The total effective rate and the effective rate in the newly treated patients in BD group were higher than those in TD group,and the differences were statistically significant(P<0.05).The increase value of hemoglobin,decrease value of serum creatinine,decrease value of serumβ2 microglobulin and decrease value of plasma cell proportion in bone marrow in BD group were higher than those in TD group,and the differences were statistically significant(P<0.05).After 4-50 months of follow-up,the survival time and survival rate in BD group were higher than those in TD group,and the differences were statistically significant(P<0.05).The incidence of fatigue,peripheral neuropathy and myelosuppression in BD group were higher than those in TD group,and the incidence of constipation,rash,drowsiness,dizziness and deep vein thrombosis were lower than those in TD group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of abdominal pain,diarrhea and herpes zoster between the two groups(P>0.05).Conclusion The efficacy of BD in the elderly patients with MM is significant,and the safety is high,which is worthy of clinical promotion.
作者
米虹燕
杨秋安
孙延庆
MI Hong-yan;YANG Qiu-an;SUN Yan-qing(Department of Radiotherapy,Qilu Hospital of Shandong University,Shandong Province,Ji′nan250012,China;Department of Hematology,Gansu Provincial Hospital,Gansu Province,Lanzhou730000,China)
出处
《中国当代医药》
CAS
2021年第13期12-16,共5页
China Modern Medicine
