硼替佐米治疗多发性骨髓瘤致消化系统自主神经病变相关研究  

Study on autonomic neuropathy of digestive system caused by bortezomib in the treatment of multiple myeloma

作　　者：赵薇薇 董秀帅[1] 刘瑶[1] 高新宇[1] 李晓云[1] 常玉莹[1] 王京华[1] 戴海滨[1] 刘娟[1] 陈丽艳[1] 王连杰[1] 王巍[1] ZHAO Weiwei;DONG Xiushuai;LIU Yao;GAO Xinyu;LI Xiaoyun;CHANG Yuying;WANG Jinghua;DAI Haibin;LIU Juan;CHEN Liyan;WANG Lianjie;WANG Wei(Department of Hematology,the Second Affiliated Hospital of Harbin Medical University,Harbin,150000,China)

机构地区：[1]哈尔滨医科大学附属第二医院血液科,哈尔滨150000

出　　处：《临床血液学杂志》2022年第7期486-489,494,共5页Journal of Clinical Hematology

摘　　要：目的:研究硼替佐米治疗多发性骨髓瘤(MM)致消化系统自主神经病变对临床疗效及生活质量的影响。方法:选取2018年1月-2021年12月收治的初诊MM患者150例,接受以硼替佐米为基础的联合方案治疗。观察消化系统自主神经病变的发生率,分析其严重程度与疗效、生存、年龄、基础疾病及个人史的相关性。结果:硼替佐米治疗MM致消化系统自主神经病变发生率达60.0%,3级消化系统自主神经病变组总有效率、2年无进展生存率、2年总生存率显著低于1~2级组,差异有统计学意义(P<0.05)。年龄、便秘、糖尿病、骨折/脊髓压迫卧床及酗酒病史与硼替佐米治疗MM致消化系统自主神经病变发生风险呈正相关(P<0.05)。经及时调整治疗方案,多数患者消化系统自主神经病变明显减轻,可继续硼替佐米治疗。结论:硼替佐米治疗MM致消化系统自主神经病变发生率高,其严重程度与临床疗效、高龄、便秘、糖尿病、骨折/脊髓压迫卧床及酗酒病史密切相关,需早期发现早期处理,以期更好地治疗疾病及逆转自主神经病变。Objective: To study the effect of autonomic neuropathy of digestive system caused by bortezomib on the clinical efficacy and quality of life in the treatment of multiple myeloma(MM). Methods: A total of 150 patients with newly diagnosed MM admitted from January 2018 to December 2021 were selected to receive bortezomib based combination therapy. The incidence of autonomic neuropathy of the digestive system was observed, and the correlation between the severity and efficacy, survival, age, underlying diseases, and personal history was analyzed. Results: The incidence of autonomic neuropathy of digestive system was 60.0%, and the overall response rate, 2-year progression-free and 2-year overall survival of grade 3 autonomic neuropathy of digestive system group were significantly lower than those of grade 1 to 2 group(P<0.05). The risk of autonomic neuropathy of digestive system was positively correlated with age, constipation, diabetes, bed rest with fracture/spinal cord compression and alcoholism(P<0.05). The autonomic neuropathy of digestive system was significantly relieved in most patients by timely adjustment of treatment regimen, and bortezomib could be used for the follow-up treatment. Conclusion: Bortezomib in the treatment of MM causes a high incidence of autonomic neuropathy in the digestive system, and its severity is closely related to clinical efficacy, age, constipation, diabetes, bed rest with fracture/spinal cord compression and alcoholism. Early detection and treatment should be carried out in order to better treat diseases and reverse autonomic neuropathy.

关 键 词：硼替佐米 多发性骨髓瘤 消化系统自主神经病变 

分 类 号：R733.3[医药卫生—肿瘤]