多发性骨髓瘤化疗后蛋白C、蛋白S活性检测
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摘要
目的观察VAD方案及联合沙利度胺治疗多发性骨髓瘤患者的蛋白C、蛋白S活性变化及临床意义。方法选取2012年2月至2016年2月我院就诊的108例多发性骨髓瘤患者,随机分为VAD治疗组(56例)和T-VAD治疗组(52例)两组。分别给予VAD化疗方案及T-VAD方案治疗,检测两组的蛋白C和蛋白S活性变化,观察血栓发病情况。结果 2个治疗组均导致蛋白C和蛋白S活性降低,治疗后6月T-VAD组比VAD治疗组降低更明显,T-VAD组治疗后6个月发生静脉血栓率约为VAD治疗组的3倍。结论 VAD化疗方案用于多发性骨髓瘤如联合沙利度胺蛋白C和蛋白S活性降低,静脉血栓发病率升高,蛋白C、蛋白S活性检测可作为应用抗凝治疗的重要参考指标。
Objective Observation of VAD chemotherapy and combined with thalidomide in the treatment of patients with multiple myeloma protein C,protein S activity and thrombosis incidence. Methods Selected from February 2011 to February 2015 in our hospital 108 cases of multiple myeloma patients,random divided into VAD treatment group( 56 cases) and T-VAD treatment group( 52 cases) two groups. The changes of protein C and protein S activity in the two groups were detected by VAD chemotherapy and T-VAD treatment,respectively,and the incidence of thrombosis was observed. Results The 2 treatment groups were induced protein C and protein S activity decreased,T-VAD group than VAD treatment group decreased more significantly after 6 months treatment,and the incidence of venous thrombosis in group T-VAD was 3 times that of VAD treatment group in 6 months. Conclusion Protein C and Protein S activity decreased in multiple myeloma treated with VAD chemotherapy if added thalidomid. the incidence of venous thrombosis rate increased,the detection of protein C and protein S activity can be used as an important reference to application of anticoagulant therapy.
Objective Observation of VAD chemotherapy and combined with thalidomide in the treatment of patients with multiple myeloma protein C,protein S activity and thrombosis incidence. Methods Selected from February 2011 to February 2015 in our hospital 108 cases of multiple myeloma patients,random divided into VAD treatment group( 56 cases) and T-VAD treatment group( 52 cases) two groups. The changes of protein C and protein S activity in the two groups were detected by VAD chemotherapy and T-VAD treatment,respectively,and the incidence of thrombosis was observed. Results The 2 treatment groups were induced protein C and protein S activity decreased,T-VAD group than VAD treatment group decreased more significantly after 6 months treatment,and the incidence of venous thrombosis in group T-VAD was 3 times that of VAD treatment group in 6 months. Conclusion Protein C and Protein S activity decreased in multiple myeloma treated with VAD chemotherapy if added thalidomid. the incidence of venous thrombosis rate increased,the detection of protein C and protein S activity can be used as an important reference to application of anticoagulant therapy.
引文
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[9]秦小玉,宋燕,陈宁恒,等.静脉血栓栓塞症患者血清T3、蛋白C、蛋白S水平临床分析.中国医药科学,2014,1(4):12-14).
[10]陆松松,吴迪,贾玫.蛋白C的检测方法及研究进展[J].实验与检验医学,2013,31(4):297-299.
[11]唐金凤,陈先春,钟磊,等.血浆凝血因子V、VIII及蛋白C活性与下肢静脉血栓形成的相关性.实验与检验医学,2015,33期.卷1:103-105.
[12]刘竹珍,李广伦,杨颉,等.临床荟萃,2014,29(2):155-158.
[13]DE MOREUIL C,IANOTTO JC,EVEILLARD JR.et al.Multiple myeloma and venous thrombosis.Which thromboprophylaxis should be given?.Rev Med Interne.2016,37:473-9.
[2]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2008:232-235.
[3]DE STEFANO V1,ZA T1,ROSSI E1.Venous thromboembolism in multiple myeloma.Semin Thromb Hemost.2014Apr;40(3):338-47.
[4]张付华,刘珍,孙学青.低剂量沙利度胺结合化疗用于老年多发性骨髓瘤中的疗效及不良反应良反应分析.中国医药导刊,2015,10:1047-1049.
[5]ZANGARI M,SIEGEL E,BARLOGIE B,et al.Thrombogenic activity of doxorubicin in myeloma patients receiving thalidomide:implications for therapy[J].Blood,2002,100:1168-1171.
[6]KRISTINSSON SY1,BJORKHOLM M,SCHULMAN S et al,Hypercoagulability in multiple myeloma and its precursor state,monoclonal gammopathy of undetermined significance.Semin Hematol.2011 Jan;48(1):46-54.
[7]REZENDE SM,SIMMONDS RE,LANE DA.Coagulation inflammation and apoptosis:different roles for protein S and the protein S-C4 b binding protein complex[J].Blood,2004,103:1192~1201.
[8]HACKENG TM,MAURISSEN LF,CASTODI E,et al.Regulation of TFPI function by protein S[J].J Thromb Haemost,2009,7(Suppl 1):165-168..
[9]秦小玉,宋燕,陈宁恒,等.静脉血栓栓塞症患者血清T3、蛋白C、蛋白S水平临床分析.中国医药科学,2014,1(4):12-14).
[10]陆松松,吴迪,贾玫.蛋白C的检测方法及研究进展[J].实验与检验医学,2013,31(4):297-299.
[11]唐金凤,陈先春,钟磊,等.血浆凝血因子V、VIII及蛋白C活性与下肢静脉血栓形成的相关性.实验与检验医学,2015,33期.卷1:103-105.
[12]刘竹珍,李广伦,杨颉,等.临床荟萃,2014,29(2):155-158.
[13]DE MOREUIL C,IANOTTO JC,EVEILLARD JR.et al.Multiple myeloma and venous thrombosis.Which thromboprophylaxis should be given?.Rev Med Interne.2016,37:473-9.