亚砷酸联合T-VAD方案对老年多发性骨髓瘤患者血清APRIL、β2-m和TPO水平的影响  

Effect of arsenious oxide combined with T-VAD program on APRIL,β2-m and TPO levels in elderly patients with multiple myeloma

作　　者：王欢[1] 陈曦[1] 李静[1] 刘艳春[1] 刘庆荣[1] 陈丽娟 

机构地区：[1]唐山工人医院血液科,河北唐山063001 [2]南京医科大学第一附属医院血液内科,江苏南京210029

出　　处：《中国生化药物杂志》2014年第5期58-60,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：国家自然科学基金(81071946)

摘　　要：目的通过分析亚砷酸联合T-VAD方案对老年多发性骨髓瘤(multiple myeloma,MM)患者的血清增殖诱导配体(a proliferation-inducing ligand,APRIL)、β2-微球蛋白(β2-microglobulin,β2-m)及血小板生成素(thrombopoietin,TPO)表达水平的变化,探讨亚砷酸联合T-VAD治疗方案在老年多发性骨髓瘤患者治疗中的价值。方法选取2012年1月~2014年1月唐山工人医院血液科治疗的88例老年多发性骨髓瘤患者作为临床研究对象,其中采取亚砷酸联合T-VAD方案治疗45例(观察组),根据Blades标准评价疗效将观察组分为有效组32例和无效组15例2个亚组;采取VAD治疗共43例(常规治疗组);选取同期体检的45例老年健康人作为对照组,采用实时荧光定量PCR检测APRIL mRNA水平,酶联免疫吸附试验法检测血清APRIL及TPO表达水平,放射免疫分析法检测β2-m,比较各组血清APRIL、β2-m及TPO表达的差异性。结果多发性骨髓瘤患者APRIL mRNA、血清APRIL、β2-m以及TPO表达水平显著高于对照组(P<0.05),经过治疗后,APRIL mRNA、血清APRIL、β2-m以及TPO浓度下降明显(P<0.05),但是仍显著高于对照组(P<0.05),并且亚砷酸联合T-VAD治疗组下降水平显著优于VAD治疗者(P<0.05);观察组中治疗有效组患者血清APRIL、β2-m以及TPO表达水平显著低于无效组(P<0.05)。结论亚砷酸联合T-VAD方案能够降低老年多发性骨髓瘤患者血清APRIL、β2-m及TPO水平,是老年多发性骨髓瘤较为有效的治疗方案之一。Objective To investigate the influence of arsenious oxide combined with T-VAD on APRIL,β2-m and TPO leves in elderly patients with multiple myeloma(MM),and evaluate its value in treatment of multiple myeloma. Methods 88 elderly patients with multiple myeloma collected in Tangshan Worker Hospital,from January 2012 to January 2014 were the subject in this study. Observation group( n = 45) were given arsenious oxide combined with T-VAD regimen,and divided into effective group(32 cases) and invalid group(15 cases) according to Blades standard; routine treatment group(n = 43) were given VAD therapy; 45 healthy elderly people undergoing physical examination were selected as control group. APRIL mRNA levels in each group were detected by real-time PCR,APRIL and TPO expression were detected by ELISA and β2-m levels were detected by radioimmunoassay. Results Compared with control group,levels of APRIL mRNA,serum APRIL,β2-m and TPO levels in other groups were all significantly higher(P < 0. 05). After treatment,those indexes were decreased significantly(P < 0. 05),but still higher than control group(P < 0. 05).and the levels of those indexes of combination treatment group were lower than those of VAD treatment group(P < 0. 05); serum APRIL,β2-m and TPO levels in effective group of observation group were significantly lower than those in invalid group( P < 0. 05). Conclusion Arsenious oxide combined with T-VAD scheme can reduce APRIL,β2-m and TPO levels in elderly patients with multiple myeloma,and it is a effective treatment method.

关 键 词：亚砷酸 T-VAD治疗 多发性骨髓瘤 老年 APRIL Β2-M TPO 

分 类 号：R246.3[医药卫生—针灸推拿学]