沙利度胺维持治疗多发性骨髓瘤的临床疗效观察  

Clinical observation of thalidomide maintenance therapy for multiple myeloma

作　　者：杜朝阳[1] 杨如玉[1] 

机构地区：[1]河南省南阳市中心医院血液科,473000

出　　处：《中国实用医刊》2014年第15期54-56,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨沙利度胺对维持治疗多发性骨髓瘤的临床治疗效果，分析沙利度胺用药后对血浆血管内皮生长因子（VEGF）、骨髓微血管密度（MVD）水平的影响及不良反应的发生情况。方法选取在南阳市中心医院住院治疗的多发性骨髓瘤患者38例为研究对象。对初治患者单纯应用沙利度胺给药治疗，若治疗无效则改用沙利度胺与VAD联合给药的方案进行化疗。对复发难治的患者则选用沙利度胺与VAD联合给药治疗。观察患者的治疗效率，比较治疗前后血清VEGF、白细胞介素石（IL-6）和患者MVD水平。结果沙利度胺维持治疗总有效率为86．8％，治疗后红细胞（Hb）含量明显升高，p2-MG和免疫球蛋白G、A的含量均较治疗前显著下降平（P〈0．05）。治疗后患者血清中的VEGF、IL-6和MVD水平均较治疗前显著下降（P〈0．05）。结论应用沙利度胺治疗多发性骨髓瘤的临床疗效值得肯定，并且患者可以耐受小剂量沙利度胺的长期性维持治疗，不良反应少，患者的生活质量可以有效提高。Objective To investigate the maintenance therapy of thalidomide in the treatment ot multiple myeloma, analyze the influence of therapy on VEGF and MVD, and analyze the occurrence of adverse reactions. Methods Thirty-eight patients with multiple myeloma were chosen for the study, all patients administered thalidomide treatment. If the treatment was ineffective, thalidomide combined with VAD chemotherapy administered programs were given. The refractory patients were given thalidomide administered combination with VAD therapy. The efficiency of treatment, serum VEGF and IL-6 levels before and after treatment, and levels of MVD were observed and compared. Results The total effective rate of thalidomide maintenance therapy was 86.8 % after treatment, the erythrocyte levels （Hb） was increased significantly, β2-MG and immunoglobulin G, A levels were decreased significantly than before treatment （P 〈 0. 05 ）. After treatment, serum VEGF, IL-6 levels and MVD were decreased significantly than before treatment （ P 〈 0.05 ）. Conclusions Thalidomide in treatment of multiple myeloma has good clinical efficacy, and the patients can tolerate the long-term maintenance therapy of small dose of thalidomide, it can effectively improve the patient＇ s quality of life.

关 键 词：沙利度胺 小剂量 多发性骨髓瘤 化疗 

分 类 号：R733.3[医药卫生—肿瘤]