摘要
目的改良PCD方案治疗多发骨髓瘤患者的疗效及其对血清铁蛋白,增殖诱导配体(APRIL)和护骨素(OPG)水平的影响。方法选择2012年1月至2013年12月多发性骨髓瘤患者76例,根据治疗方法不同分为观察组和对照组,每组38例。对照组予以PCD方案化疗,观察组予以改良PCD方案化疗。观察2组治疗后的疗效和毒副作用,治疗前后血红蛋白、β2-MG、骨髓浆细胞比例、KPS、铁蛋白、APRIL和OPG水平变化。结果观察组总有效率为78. 95%,对照组总有效率为68. 42%,2组疗效差异无统计学意义(χ2=0. 611,P> 0. 05)。治疗后观察组在乏力、胃肠道反应和血液毒性发生率方面明显低于对照组(P <0. 05),而2组在周围神经炎和感染方面差异无统计学意义(P>0. 05)。2组治疗前血红蛋白、β2-MG、骨髓浆细胞比例、KPS铁蛋白、APRIL和OPG比较差异无统计学意义(P>0. 05),治疗后2组血红蛋白、KPS和OPG较治疗前明显升高(P <0. 01),而β2-MG、骨髓浆细胞比例、铁蛋白和APRIL较治疗前明显降低(P <0. 01),观察组血红蛋白、β2-MG、铁蛋白、APRIL和OPG水平较对照组升高或降低更加明显(P <0. 01)。结论改良PCD方案治疗多发骨髓瘤患者疗效确切,具有毒副作用小,可能与降低机体的铁蛋白和APRIL水平,升高机体的OPG水平有关。
Objective To investigate the curative effects of improved PCD regimen on multiple myeloma,and to observe its effects on serum levels of ferritin,proliferation-inducing ligand(APRIL)and osteoprotegerin(OPG)levels of patients with multiple myeloma.Methods A total of 76 patients with multiple myeloma who were admitted and treated in our hospital from January 2012 to December 2013 were enrolled in the study.According to different therapeutic methods,these patients were divided into observation group(n=38)and control group(n=38).The patients in control group received PCD regimen chemotherapy,however,the patients in observation group received modified PCD regimen chemotherapy.The curative effects and side effects were observed and compared between the two groups.Moreover the changes of hemoglobin,β2-MG,bone marrow plasma cells,KPS,ferritin,APRIL and OPG before and after treatment were observed and compared between the two groups.Results The total effective rate was 78.95%in observation group,and 68.42%in control group,there was no significant difference between the two groups(χ^2=0.611,P >0.05).After treatment,the fatigue symptom,gastrointestinal reactions and incidence of hematotoxicity in observation group were significantly lower than those in control group(P<0.05),while there were no significant differences in peripheral neuritis and incidence of infection between the two groups(P >0.05).Before treatment there were no significant differences in the levels of hemoglobin,β2-MG,bone marrow plasma cell ratio,KPS,ferritin,APRIL and OPG between the two groups(P >0.05).After treatment,the levels of hemoglobin,KPS and OPG were significantly increased in both groups,as compared with those before treatment(P<0.01),however,the levels ofβ2-MG and bone marrow plasma cells,ferritin and APRIL were significantly decreased,as compared with those before treatment(P<0.01),moreover the increasing or decreasing levels of hemoglobin,β2-MG,ferritin,APRIL and OPG in observation group were more significant than those in control group(P<0.01).Conclusion The modified PCD regimen has definite therapeutic effects on multiple myeloma,with fewer toxicity and side effects,which may be related to the decrease of ferritin and APRIL levels as well as the increase of OPG levels in the body.
作者
范小红
孙丽华
FAN Xiaohong;SUN Lihua(Department of Hematology,Qingpu Branch of Zhongshan Hospital,Shanghai 201700,China)
出处
《河北医药》
CAS
2019年第3期407-410,共4页
Hebei Medical Journal
关键词
多发骨髓瘤
化疗
疗效
铁蛋白
增殖诱导配体
护骨素
multiple myeloma
chemotherapy
curative effects
ferritin
proliferation-inducing ligand
osteoprotegerin
