环磷酰胺联合VAD方案对多发性骨髓瘤的临床及影像学疗效评价  

Clinical and Imageological Effect of Cyclophosphamide Combined with VAD Regimen in Treatment of Multiple Myeloma

作　　者：周向海 刘海英[1] 华定新[1] 陈晋平[1] 

机构地区：[1]河北省廊坊市中医院放射科,河北廊坊065000

出　　处：《中国药业》2015年第8期35-37,共3页China Pharmaceuticals

摘　　要：目的观察环磷酰胺联合VAD化学治疗(简称化疗)方案治疗多发性骨髓瘤(MM)的临床疗效及其X线摄片特点。方法回顾性分析医院2009年至2012年收治的148例MM患者的临床资料,总结X线摄片的诊断特点,并根据治疗方案分为联合组(环磷酰胺+VAD,78例)和对照组(VAD,70例),比较两组患者治疗6个周期后的临床疗效及不良反应发生情况。结果 148例MM患者中,头颅平片阳性率最高,与其他体位比较有显著性差异(χ2=142.936,P<0.05)。治疗6个周期后,联合组的病灶缩小率为47.44%,显著高于对照组的31.43%(P<0.05);联合组的病灶扩大率为14.10%,显著低于对照组的30.00%(P<0.05);两组间的病灶消失率、病灶稳定率比较,差异无统计学意义(P>0.05);联合组的总有效率为74.36%,显著高于对照组的54.29%(P<0.05);联合组的不良反应发生率为69.23%,与对照组的61.43%比较无显著性差异(P>0.05)。结论 MM患者的X线摄片表现具有典型特征,头颅阳性率较高;环磷酰胺联合VAD化疗方案临床疗效更好,且不会增加不良反应的发生,值得临床推广。Objective To observe the clinical effect and X- ray radiography characteristic of cyclophosphamide combined with tbe VAD chemotherapy regimen for treating multiple myeloma（MM）. Methods The clinical data in 148 cases of MM in our hospital from 2009 to 2012 were analyzed retrospectively. The characteristics of X- ray radiography in MM were summarized. The patients were divided into the combined group （cyclophosphamide ＋ VAD,78 cases） and the control group （VAD,70 cases） according to the treatment re- gimens. The differences in the clinical effects and adverse reactions after 6-cycle treatment were compared between the two groups. Results In 148 cases of MM, the positive rate was highest in head plain film, showing significant differences compared with other positions （X2= 142. 936, P 〈 0.05）.The lesion minification rate after 6-cycle therapy in the combined group was 47.44% , which was significantly higher than 31.43% in the control group（P 〈 0.05）,the lesion expansion rate in the combined group was 14. 10% ,which was significantly lower than 30. 00% in the control group（P 〈 0.05）;the lesion disappearance rate and lesion stability rate had no statistically significant differences between the two groups（P 〉 0. 05）;the total effective rate in the combined group was 74. 36% , which was significantly higher than 54.29% in control group（P 〈 0.05）. The incidence rate of adverse reactions was 69.23% in the combined group and 61.43% in the control group,but the difference was not statistically significant（P 〉 0.05）. Conclusion The X-ray image manifestations of MM have typical characteristics, and the positive rate is higher in the skull; cy- clophosphamide combined with VAD chemotherapy regimen has better effect without increasing the occurrence of adverse reactions and deserves in clinical promotion.

关 键 词：多发性骨髓瘤 X线摄片 环磷酰胺 化学治疗 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]