VP与VAD方案治疗多发性骨髓瘤患者化疗后感染的研究  

Effects of VP and VAD on treatment of multiple myeloma patients with infections after chemotherapy

作　　者：骆林胜[1] 林洁[2] 丁香翠[1] 冯爱梅[1] 吴品[3] 张日[3] 

机构地区：[1]温州医科大学附属第三医院血液科,浙江温州325200 [2]温州医科大学附属第三医院药学部,浙江温州325200 [3]苏州大学附属第一医院血液科,江苏苏州215006

出　　处：《中华医院感染学杂志》2016年第9期2088-2089,2095,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2011KYB111)

摘　　要：目的探讨应用化疗药物治疗多发性骨髓瘤的疗效,以及化疗后并发感染的治疗效果,为临床治疗多发性骨髓瘤及化疗后感染提供理论依据。方法选取2012年8月-2015年8月于医院接受治疗的初次诊断为多发性骨髓瘤的患者50例作为本研究对象,将患者随机分为A、B两组,各25例;A组患者应用VP（长春新碱＋硼替佐米）治疗方案,B组应用VAD（长春新碱＋阿霉素＋地塞米松）治疗方案,比较两组患者的临床疗效及感染情况。结果 A组患者中总缓解率为84.0%;B组患者总缓解率为60.0%;A组的缓解率明显高于B组,差异有统计学意义（P〈0.05）;随访两组患者1~3年,A组患者病死率为8.0%,明显低于B组的32.0%,组间比较差异有统计学意义（P〈0.05）;A组患者血小板减少发生率为40.0%,粒细胞减少发生率为28.0%,感染率为20.0%,B组患者分别为40.0%、68.0%和56.0%,组间比较差异有统计学意义（P〈0.05）。结论 VP方案治疗多发性骨髓瘤的临床疗效明显、感染率低、不良反应轻、易于患者接受,值得临床推广使用。OBJECTIVE To observe the effects of VP（vincristine plus bortezomib）and VAD（vincristine plus adriamycin plus dexamethasone）on treatment of the multiple myeloma patients complicated with infections after chemotherapy so as to provide theoretical basis for clinical treatment of multiple myeloma complicated with infections after chemotherapy.METHODS A total of 50 patients with primary diagnosis of multiple myeloma who were treated in the hospitals from Aug 2012 to Aug 2015 were recruited as the study objects and randomly divided into the group A and the group B,with 25 cases in each.The group A was treated with VP,the group B was given VAD,and the clinical effects and incidence of infections were observed and compared between the two groups of patients.RESULTS The total remission rate of the group A was 84.0%,significantly higher than 60.0% of the group B（P〈0.05）.The follow-up was conducted for the two groups of patients for 1-3years,and it revealed that the mortality of the group A was 8.0%,significantly lower than 32.0% of the group B（P〈0.05）.The incidence rate of thrombocytopenia was 40.0% in the group A,40.0% in the group B;the incidence rate of neutropenia was28.0%in the group A,68.0%in the group B;the infection rate was 20.0%in the group A,56.0%in the group B,and there was significant between-group difference（P〈0.05）.CONCLUSION The VP program can achieve significant clinical effect on treatment of multiple myeloma,with the infection rate low,adverse reactions mild,and it is worthy to be promoted in the hospital.

关 键 词：VP方案 VAD方案 初诊 多发性骨髓瘤 化疗 感染 临床疗效 

分 类 号：R733.3[医药卫生—肿瘤]