硼替佐米对多发性骨髓瘤患者免疫功能及肾功能的影响  

Effects of bortezomib on immune function and renal function in patients with multiple myeloma

作　　者：武金日 卢秀利 沈玉敬 邢会茹 秦卫玲[1] WU Jinri;LU Xiuli;SHEN Yujing;XING Huiru;QIN Weiling(Department of Hematology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,He’nan,China)

机构地区：[1]新乡医学院第三附属医院血液内科,河南新乡453000

出　　处：《癌症进展》2024年第14期1540-1543,共4页Oncology Progress

基　　金：2022年度河南省医学科技攻关计划联合共建项目(LHGJ20220640)。

摘　　要：目的探讨硼替佐米对多发性骨髓瘤患者免疫功能及肾功能的影响。方法根据治疗方式的不同将70例多发性骨髓瘤患者分为长春新碱组(n=34,长春新碱联合地塞米松与沙利度胺)和硼替佐米组(n=36,硼替佐米联合地塞米松与沙利度胺),比较两组患者的临床疗效、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、肾功能指标[血尿素氮(BUN)、血清肌酐(SCr)]、M蛋白水平及骨髓瘤细胞数。结果硼替佐米组患者的治疗总有效率高于长春新碱组,差异有统计学意义(P﹤0.05)。治疗后,两组患者CD3^(+)、CD4^(+)、SCr、BUN水平及CD4^(+)/CD8^(+)均高于本组治疗前,CD8^(+)、M蛋白水平均低于本组治疗前,骨髓瘤细胞数均少于本组治疗前,硼替佐米组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于长春新碱组,CD8^(+)、SCr、BUN、M蛋白水平均低于长春新碱组,骨髓瘤细胞数少于长春新碱组,差异均有统计学意义(P﹤0.05)。结论硼替佐米联合地塞米松与沙利度胺可以改善多发性骨髓瘤患者的免疫功能,抑制M蛋白和骨髓瘤细胞生成,提高临床疗效,且对肾功能损害较小。Objective To investigate the effects of bortezomib on immune function and renal function in patients with multiple myeloma.Method A total of 70 patients with multiple myeloma were divided into vincristine group(n=34,vincristine combined with dexamethasone and thalidomide)and bortezomib group(n=36,bortezomib combined with dexamethasone and thalidomide)according to different treatment methods.The clinical efficacy,immune function indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),renal function indexes[blood urea nitrogen(BUN),serum creatinine(SCr)],M protein level and number of myeloma cells were compared between the two groups.Result The total effective rate of bortezomib group was higher than that of vincristine group,and the difference was statistically significant(P<0.05).After treatment,the CD3^(+),CD4^(+),SCr,BUN levels and CD4^(+)/CD8^(+)in two groups were higher than those before treatment,the CD8^(+)and M protein levels were lower than those before treatment,the number of myeloma cells were less than those before treatment,the CD3^(+),CD4^(+)levels and CD4^(+)/CD8^(+)in bortezomib group were higher than those in vincristine group,the CD8^(+),SCr,BUN and M protein levels were lower than those in vincristine group,the number of myeloma cells was less than that in vincristine group,and the differences were statistically significant(P<0.05).Conclusion Bortezomib combined with dexamethasone and thalidomide can improve immune function in patients with multiple myeloma,inhibit M protein and myeloma cell generation,enhance clinical efficacy,and have less damage to renal function.

关 键 词：多发性骨髓瘤 硼替佐米 免疫功能 肾功能 临床疗效 

分 类 号：R733.3[医药卫生—肿瘤]