VAD方案和VD方案治疗初诊多发性骨髓瘤的效果比较

发布时间：2018-07-02 14:06

本文选题：多发性骨髓瘤 + 硼替佐米　；参考：《中国老年学杂志》2017年02期

【摘要】：目的比较VAD方案和VD方案治疗初诊多发性骨髓瘤的临床疗效及副作用。方法 70例MM患者依据治疗方案分为VAD组(59例)和VD组(11例)。VAD组接受长春新碱、阿霉素及地塞米松治疗;VD组接受硼替佐米联合地塞米松治疗。结果患者初次化疗前后血钙下降值、β2-微球蛋白下降值、Ig G和Ig A下降值在两组之间有统计学意义(P0.05);血红蛋白增长值、白蛋白增长值、球蛋白下降值在两组间无统计学意义(P0.05)。VAD组中相关症状改善占28.8%(17/59),VD组中占63.6%(7/11),两组相比有统计学意义(P0.05)。VAD组主要不良反应为胃肠道反应、感染及末梢神经炎,有54.2%(32/59)的患者在初次化疗出现了相关不良反应,其中感染多在3度以上。VD组不良反应多为胃肠道反应、腹泻和末梢神经炎,有27.3%(3/11)出现症状,症状较轻,经停药和对症处理后症状消失或缓解。结论 VD方案对初诊MM患者的初次化疗中血钙、β2-微球蛋白、Ig G/Ig A恢复效果明显,症状改善率大于VAD组,同时其副作用较轻微,患者较易耐受,可在临床推广。
[Abstract]:Objective to compare the clinical effects and side effects of VAD regimen and VD regimen in the treatment of newly diagnosed multiple myeloma. Methods 70 patients with MM were divided into two groups: VAD group (59 cases) and VD group (11 cases). VAD group received vincristine, adriamycin and dexamethasone were treated with bortezomil combined with dexamethasone. Results the decrease of serum calcium, 尾 2-microglobulin and IgG and IgA were statistically significant between the two groups before and after the first chemotherapy (P0.05), the increase of hemoglobin, the increase of albumin, There was no significant difference in the decrease of globulin between the two groups (P0.05). The improvement of related symptoms in the VAD group was 28.8% (17 / 59). There was significant difference between the two groups (P0.05). The main adverse reactions of VAD group were gastrointestinal reaction, infection and peripheral neuritis. 54.2% (32 / 59) of the patients had adverse reactions related to the initial chemotherapy, and most of the adverse reactions were gastrointestinal reactions, diarrhea and peripheral neuritis, and 27.3% (3 / 11) of the patients had mild symptoms. Symptoms disappeared or alleviated after withdrawal and symptomatic treatment. Conclusion the effect of VD regimen on the recovery of serum calcium and 尾 2-microglobulin Ig G / Ig A in patients with newly diagnosed MM was obvious, the improvement rate of symptoms was higher than that in VAD group, and the side effects of VD regimen were mild, the patients were easily tolerated, and could be popularized in clinical practice.
【作者单位】：南昌大学医学院;南昌大学;赣南医学院第一附属医院;
【基金】：国家自然科学基金资助项目(81160073) 江西省自然科学基金(20122BAB205024)
【分类号】：R733.3

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