环磷酰胺联合MP方案治疗多发性骨髓瘤的疗效及对血清C反应蛋白、乳酸脱氢酶、白蛋白和β2微球蛋白的影响  

The clinical study of efficacy of cyclophosphamide plus MP for patients with multiple myeloma and its influ-ence on serum CRP,LDH,Alb and β2 -MG

作　　者：吴玲 

机构地区：[1]重庆三博长安医院内2科,重庆市400023

出　　处：《中国基层医药》2015年第17期2567-2570,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨环磷酰胺联合MP（美法仑＋泼尼松）方案治疗多发性骨髓瘤（MM）的临床效果、不良反应及对血清C反应蛋白（CRP）、乳酸脱氢酶（LDH）、白蛋白（Alb）和β2微球蛋白（β2-MG）的影响。方法选取初诊多发性骨髓瘤患者61例，按照入院前后顺序进行编号，并根据随机数字表法分为治疗组和对照组。治疗组（32例）给予环磷酰胺联合MP方案，对照组（29例）仅给予MP方案治疗。28 d为1个疗程，连续治疗4个疗程后评价两组疗效及不良反应，并比较治疗前后CRP、LDH、Alb和β2-MG的变化。结果治疗组总有效率（ORR）为90．63％，其中，完全缓解率（CR）37．50％，非常好的部分缓解率（VGPR）25．00％，部分缓解率（PR）28．13％；对照组ORR为62．06％，其中，CR 10．34％，VGPR 17．24％，PR 34．48％。两组CR、ORR差异均有统计学意义（χ2＝6．050、7．015，P＝0．013、0．008）。两组出现的不良反应有白细胞减少、血小板减少、周围神经病变、肝损伤、乏力和血栓等，而上述不良反应和总不良反应率差异均无统计学意义（P＞0．05）。两组治疗后的血清CRP、LDH和β2-MG较治疗前均明显降低（t＝7．321、4．972、7．668、5．174、4．231、2．379，均P＜0．05），且治疗组降低更明显（t＝－2．097、－2．409、－2．112，均P＜0．05）；而两组治疗后Alb含量明显升高（t＝－4．170、－2．805，均P＜0．05），且治疗组升高更明显（t＝1．710，P＜0．05）。结论环磷酰胺联合MP方案CR和ORR显著优于单纯MP方案，不良反应未见增多，可以较明显地降低血清CRP、LDH和β2-MG，并升高Alb含量，从而更好地减轻患者肿瘤负荷，提高治疗效果，且安全性较好。Objective To explore the therapeutic efficacy and safety of cyclophosphamide combined with MP for patients with multiple myeloma （MM）,as well as its influence on serum CRP,LDH,albumin （Alb）and β2 -microglobulin （β2 -MG）.Methods 6 1 patients diagnosed MM in our hospital were divided into two groups random-ly：32 cases in the treatment group were given the regimen of cyclophosphamide combined with MP,and 29 cases in the controlled group were given the regimen of MP.After four periods of treatment,the curative effects and side effects of two groups were evaluated,besides,the changes of serum CRP,LDH,Alb and β2 -MG were compared.Results In the treatment group,the ORR was 90.63%,CR was 37.50%,VGPR was 25.00%,PR was 28.13%.And in the controlled group,the ORR was 62.06%,CR was 10.34%,VGPR was 17.24%,PR was 34.48%.The further studies shows that the CR and ORR between the two groups were significantly different （χ2 =6.050,7.015,P=0.013, 0.008）.Moreover,the side effects included hematological toxicities and non-hematological toxicities which were not different notably （P〉0.05）.In addition,the serum CRP,LDH andβ2 -MG were decreased after the treatment nota-bly （t=7.321,4.972,7.668,5.174,4.231,2.379,all P〈0.05）,especially in the treatment group （t=-2.097,-2.409,-2.112,all P〈0.05）;the Alb was increased compared to precious notably （t=-4.170,-2.805,all P〈0.05）,especially in the treatment group （t=1.710,P〈0.05）.Conclusion The regimen of cyclophosphamide com-bined with MP is an effective and safe therapy for multiple myeloma which seems significantly superior to MP regimen with higher CR and ORR and which can also lower CRP,LDH,β2 -MG and raise Alb to cut down the burden of tumor.

关 键 词：多发性骨髓瘤 环磷酰胺 MP方案 C反应蛋白质 乳酸脱氢酶 白蛋白 β2 微球蛋白 

分 类 号：R733.3[医药卫生—肿瘤]