硼替佐米联合地塞米松治疗多发性骨髓瘤对患者骨代谢及免疫功能的影响  

Influence of Bortezomib Combined with Dexamethasone on Bone Metabolism and Immune Function in Patients with Multiple Myeloma

作　　者：雷丽华[1] 何东[1] 林娟[1] 费晓丽 熊梅 候铮 LEI Lihua;HE Dong;LIN Juan(Chengdu First People's Hospital,Chengdu,610000)

机构地区：[1]成都市第一人民医院,610000

出　　处：《实用癌症杂志》2020年第6期917-920,共4页The Practical Journal of Cancer

摘　　要：目的探讨硼替佐米联合地塞米松治疗多发性骨髓瘤(MM)对患者骨代谢及免疫功能的影响。方法选取MM患者106例,依据随机数字表法将所有患者分为实验组(n=53)与对照组(n=53),对照组采用环磷酰胺、沙利度胺和地塞米松化疗方案,实验组采用硼替佐米^+地塞米松化疗方案,2组均治疗6个月。比较2组患者治疗前后血清Ca、P、骨代谢因子水平及免疫功能变化,记录2组不良反应情况。结果与治疗前比较,治疗6个月2组患者血清Ca、P水平均明显降低,且实验组明显低于对照组(P<0.05或P<0.01)。与治疗前比较,治疗6个月2组患者血清ALP、BGP水平均明显升高,且实验组明显高于对照组(P<0.01);2组血清CTX-Ⅰ水平明显降低,且实验组明显低于对照组(P<0.01)。与治疗前比较,治疗6个月2组患者全血中CD3^+、CD4^+比例和CD4^+/CD8^+均明显升高,且实验组明显高于对照组(P<0.05或P<0.01);2组CD8^+比例均明显降低,且实验组明显低于对照组(P<0.05或P<0.01)。2组总不良反应发生率无统计学差异(P>0.05)。结论硼替佐米联合地塞米松可更有效地调节MM患者血清Ca、P水平,促进骨质形成,恢复溶骨和成骨平衡,调节患者机体免疫功能,安全有效,建议临床推广使用。Objective To study the influence of bortezomib combined with dexamethasone on bone metabolism and immune function in patients with multiple myeloma(MM).Methods 106 patients with MM were selected and randomly divided into the experiment group(n=53)and the control group(n=53)according to random number table methods,the control group was treated with phosphoramide,thalidomide and dexamethasone,the experiment group was treated with bortezomib combined with dexamethasone,the 2 groups were treated continuously for 6 months.The levels of serum Ca,P,bone metabolic factors and immune function were compared before and after treatment in the 2 groups,the adverse reactions of the 2 groups were recorded.Results Compared with before treatment,the serum levels of Ca and P significantly decreased after treatment in the 2 groups,and the experiment group was significantly lower than the control group(P<0.05 or P<0.01).Compared with before treatment,the serum levels of ALP,BGP significantly increased after treatment in the 2 groups,and the experiment group was significantly higher than the control group(P<0.01);the levels of CTX-Ⅰsignificantly decreased in the 2 groups,and the experiment group was significantly lower than the control group(P<0.05 or P<0.01).Compared with before treatment,the ratio of CD3^+,CD4^+and CD4^+/CD8^+in whole blood significantly increased after treatment in the 2 groups,and the experiment group was significantly higher than the control group(P<0.05 or P<0.01);the ratio of CD8^+significantly decreased in the 2 groups,and the experiment group was significantly lower than the control group(P<0.05 or P<0.01).There was no significant difference in the incidence of total adverse reactions between the 2 groups(P>0.05).Conclusion Bortezomib combined with dexamethasone can more effectively regulate serum levels of Ca,P in patients with MM,promote bone formation,restore bone and bone formation balance,regulate the immune function of patients,safe and effective,and it is recommended to use in clinic.

关 键 词：硼替佐米 地塞米松 多发性骨髓瘤 骨代谢 免疫功能 

分 类 号：R733.3[医药卫生—肿瘤]