硼替佐米对多发性骨髓瘤合并前列腺癌患者T淋巴细胞亚群分布、骨代谢及DU145和PC-3表达的影响  

Effects of bortezomib on T lymphocyte subsets distribution,bone metabolism,DU145 and PC-3 expressions in patients with multiple myeloma complicated with prostate cancer

作　　者：钱杭丹 方国华 娄漓江 QIAN Hangdan;FANG Guohua;LOU Lijiang(Department of Clinical Laboratory,Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University(Xiaoshan District Hospital of TCM),Hangzhou 311200,China)

机构地区：[1]浙江中医药大学附属江南医院(萧山区中医院)检验科,浙江杭州311200 [2]宁海县第一医院血液科

出　　处：《全科医学临床与教育》2023年第9期805-809,共5页Clinical Education of General Practice

摘　　要：目的探究硼替佐米对多发性骨髓瘤(MM)合并前列腺癌患者T淋巴细胞亚群分布、骨代谢及DU145和PC-3表达的影响。方法选取110例MM合并前列腺癌患者为本次研究对象,按照不同治疗方式分为观察组和对照组,每组患者55例,对照组患者采用沙利度胺联合环磷酰胺和地塞米松治疗,观察组患者在对照组基础上联合硼替佐米治疗,21 d为1个疗程,治疗4~8个疗程,随访6个月。比较两组患者的治疗效果、不良反应情况、治疗前后免疫功能情况。结果观察组治疗有效率为87.27%,明显高于对照组患者67.27%,差异有统计学意义(χ^(2)=4.29,P<0.05);治疗后,观察组CD^(4+)表达水平CD^(4+)/CD^(8+)高于对照组,CD^(8+)表达低于对照组,差异均有统计学意义(t分别=3.94、4.29、3.99,P均<0.05);两组患者均未发生严重的不良反应事件,其中对照组患者不良反应发生率为52.73%,观察组发生率为56.36%,差异无统计学意义(χ^(2)=1.00,P>0.05)。两组治疗后M蛋白含量、骨髓细胞含量、β2微球蛋白(β2-MG)、血红蛋白(Hb)水平比较,差异有统计意义(t分别=5.02、9.73、11.73、7.46,P均<0.05)。治疗后,观察组骨痛评分明显低于对照组(t=12.08,P<0.05)。治疗后,观察组腰椎、股骨颈、全髋骨密度(BMD)高于对照组(t分别=6.29、6.65、6.79,P均<0.05)。硼替佐米对DU145和PC-3细胞增殖均有显著效果。观察组DU145细胞和PC-3细胞均高于对照组,差异均有统计学意义(t分别=3.98、7.10,P均<0.05)。结论环磷酰胺联合硼替佐米及地塞米松对MM合并前列腺癌患者临床疗效更好,抑制前列腺癌细胞DU145和PC-3增殖,副作用可控,能有效改善患者免疫功能。Objective To investigate the effects of bortezomib on the distribution of T lymphocyte subsets,bone metab⁃olism,DU145 and PC-3 expressions in patients with multiple myeloma complicated with prostate cancer.Methods To⁃tally 110 patients with multiple myeloma complicated with prostate cancer were selected as the subjects of this study and divided into observation group and control group according to different treatment methods,55 patients in each group.The control group was treated with thalidomide combined with cyclophosphamide and dexamethasone,and the observation group was treated with bortezomib on the basis of the control group,21 days as one course of treatment,treating for 4 to 8 courses of treatment,and followed-up for 6 months.The therapeutic effect,adverse reactions and immune function be⁃fore and after treatment were compared between the two groups.Results The effective rate of the observation group was 87.27%,which was significantly higher than that of the control group 67.27%,the difference was statistically significant(χ^(2)=4.29,P<0.05).After treatment,CD^(4+)and CD^(4+)/CD^(8+)expression in observation group were higher than that in control group,and CD^(8+)expression was lower than that in control group,with statistical significance(t=3.94,4.29,3.99,P<0.05).No serious adverse events occurred in the two groups,among which the incidence of adverse events was 52.73%in the control group and 56.36%in the observation group,with no statistical significance(χ^(2)=1.00,P>0.05).There were statistically significant differences in M protein content,bone marrow cell content,β2-MG and Hb levels between the two groups after treatment(t=5.02,9.73,11.73,7.46,P<0.05).After treatment,the bone pain score of the observation group was significantly lower than that of the control group(t=12.08,P<0.05).After treatment,BMD of lumbar spine,femoral neck and total hip in observation group were higher than the control group(t=6.29,6.65,6.79,P<0.05).Bortezomib had significant effect on the proliferation of DU145 and PC

关 键 词：硼替佐米 多发性骨髓瘤 地塞米松 环磷酰胺 免疫功能 毒副作用 

分 类 号：R733.3[医药卫生—肿瘤] R737.25[医药卫生—临床医学]