摘要
目的:探讨不同剂量沙利度胺联合化疗方案治疗老年多发性骨髓瘤的临床疗效。方法:选取老年多发性骨髓瘤患者共61例,随机分为A组(31例)和B组(30例)。A组给予沙利度胺(400 mg/d)+VAD化疗方案,B组给予沙利度胺(100 mg/d)+VAD化疗方案。比较2组临床疗效及不良反应。结果:A组与B组治疗有效率分别为83.9%和76.7%(P>0.05)。治疗后2组患者血M蛋白、尿素氮、骨髓浆细胞计数均显著降低,血红蛋白及Kamofsky评分均显著提高(均P<0.05);治疗后2组患者血M蛋白、血红蛋白、尿素氮、骨髓浆细胞计数及Kamofaky评分比较无统计学差异(P>0.05)。B组便秘、口鼻黏膜干燥、乏力、头晕等不良反应发生率显著低于A组(P<0.05或P<0.01);2组腹胀、恶心、皮疹等发生率比较无统计学差异(P>0.05)。治疗后B组股静脉血流峰速度和平均速度均显著提高(P<0.05);治疗6个月后B组的肢端疼痛、感觉障碍、麻木感及不宁腿综合征等临床症状较A组改善明显(P<0.05);B组各感觉神经传导速度改善明显优于A组(P<0.05)。结论:100 mg/d沙利度胺或400 mg/d沙利度胺联合VAD方案治疗老年多发性骨髓瘤的临床疗效近似,100 mg/d沙利度胺联合VAD方案治疗多发性骨髓瘤的不良反应更轻。
Objective： To evaluate the effect of different doses of thalidomide combined with chemotherapy regimens on old patients with multiple myeloma. Methods： Sixty-one old patients with multiple myeloma were randomly divided into group A（ 31 cases） and group B（ 30 cases）. Group A was given thalidomide（ 400 mg / day） combined with VAD chemotherapy regimens. Group B was given thalidomide（ 100 mg / day） combined with VAD chemotherapy regimens. The clinical efficacy,clinical indicators and adverse reactions were compared between the two groups. Results： The response rate in group A and group B was 83. 9% and 76. 7% respectively（ P〈0. 05）. After treatment,serum M protein,urea nitrogen,and bone marrow plasma cell counts in both two groups were significantly decreased,and hemoglobin and Kamofsky scores were significantly increased as compared with those before treatment（ all P〈0. 05）. After treatment,blood M protein,hemoglobin,blood urea nitrogen,bone marrow plasma cell counts and Kamofaky score showed no significant differences between two groups（ P〈0. 05）. The incidence of constipation,mouth nasal drying,fatigue,dizziness and other adverse events in group B was significantly lower than those in group A（ P〈0. 05 or P〈0. 01）. There were no significant differences in abdominal distension,nausea and skin rash between two groups（ P〈0. 05）. After the intervention,the femoral vein blood flow peak velocity and average speed in group B were significantly increased as compared with those in group A（ P〈0. 05）. After treatment for 6 months,limb pain,sensory disturbances,numbness and restless legs syndrome were significantly alleviated in group B as compared with those in group A（ P〈0. 05）. The sensory nerve conduction velocity was increased significantly in group B as compared with those in group A（ P〈0. 05）. Conclusion： 100 mg / day thalidomide or 400 mg / day thalidomide combined with VAD chemotherapy regimens in the treatment of multiple myeloma has similar clinical efficacy,but 100 mg /day thalidomide combined with VAD chemotherapy regimens exerts mild side-effect.
出处
《内科急危重症杂志》
2016年第6期449-451,456,共4页
Journal of Critical Care In Internal Medicine
