摘要
目的:本研究主要对比硼替佐米和长春新碱联合地塞米松、沙利度胺对多发性骨髓瘤患者免疫功能、机体炎症反应、肾功能、骨髓瘤细胞及M蛋白的影响。方法:选取在我院接受治疗的68例多发性骨髓瘤患者,根据化疗使用的药物分为对照组和观察组,对照组给予长春新碱联合地塞米松与沙利度胺治疗,观察组给予硼替佐米联合地塞米松与沙利度胺治疗。检测两组治疗前后免疫细胞(CD3~+、CD4~+、CD4~+/CD8~+、Treg)、炎症因子(CRP、TNF-α)、肾功能(SCr、BUN)、骨髓瘤细胞及M蛋白等生化指标。结果:观察组化疗后CD3~+、CD4~+、CD4~+/CD8~+、Treg明显优于对照组,两组比较差异具有统计学意义(P<0.05);观察组炎症因子CRP、TNF-α水平显著降低,差异具有统计学意义(P<0.05);观察组骨髓瘤细胞、M蛋白水平明显低于对照组,肾功能SCr、BUN改善程度显著优于对照组,差异均具有统计学意义(P<0.05)。结论:硼替佐米联合地塞米松和沙利度胺化疗方案可有效降低多发性骨髓瘤患者炎症反应、M蛋白及骨髓瘤细胞,改善患者机体免疫功能及肾功能,具有一定的临床推广应用价值。
Objective: In this study, the effects of bortezomib and vincristine combined with dexamethasone and thalidomide on immune function, inflammatory response, renal function, myeloma cells and plasma cells in patients with multiple myeloma were compared. Methods: 68 patients with multiple myeloma treated in our hospital from May 2009 to Nov. 2018 were selected and divided into control group and observation group according to the drugs used in chemotherapy. The control group was treated with vincristine combined with dexamethasone and thalidomide, while the observation group was treated with bortezomib combined with dexamethasone and thalidomide.Immunocytes, inflammatory cytokines, serum creatinine, blood urea nitrogen, myeloma cells and plasma cells were detected before and after treatment in the two groups. Results: There was no significant difference in each index between the two groups before treatment(P>0.05). After three courses of chemotherapy, CD3~+, CD4~+, CD4~+/CD8~+ and Treg in the observation group were significantly better than those in the control group, and the difference between the two groups was statistically significant(P<0.05). The levels of inflammatory cytokines CRP, TNF-α, myeloma cells and M protein were significantly decreased in the observation group(P<0.05). Renal function indexes in the observation group were significantly higher than those in the control group(P<0.05). There was no significant difference in clinical efficacy and adverse reactions between the two groups(P<0.05). Conclusion:Bortezomib combined with dexamethasone and thalidomide can effectively reduce the inflammatory response, M protein and myeloma cells in patients with MM, significantly improve the immune function and renal function in patients, which has certain clinical application value.
引文
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