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目的:对应用沙利度胺联合VAD方案治疗多发性骨髓瘤(MM)的临床疗效及不良反应进行评价。方法:将42例初诊为MM患者,采用随机数字表法分为2组行对比治疗,其中,对照组采用VAD方案,治疗组在对照组VAD化疗方案的基础上联合沙利度胺,沙利度胺起始剂量100mg.d-1,分早晚口服,每周递增50mg,最大剂量300mg.d-1。2组均治疗3个疗程。结果:经过3个疗程的治疗后,治疗组22例患者,部分缓解12例,总有效率77.3%;对照组20例,部分缓解4例,总有效率55.0%,2组有效率比较差异有显著性(P<0.05);在M-蛋白、骨髓浆细胞数及β2-微球蛋白等各项指标方面,2组与治疗前比较均有明显下降,而血红蛋白有显著上升,治疗组更为明显,差异有统计学意义(P<0.05);治疗后各项指标组间比较差异有显著性(P<0.05)。结论:较单用VAD方案,沙利度胺联合VAD方案在治疗多发性骨髓瘤的临床疗效上更为显著,且具有副作用少、耐受性好等优点,值得临床推广应用。
Objective: To evaluate the clinical efficacy and side effects of thalidomide combined with VAD regimen in the treatment of multiple myeloma (MM). Methods: Forty-two newly diagnosed MM patients were divided into two groups by random number table. The control group was treated with VAD. The treatment group was treated with Vital-Thalidomide, Degree of amiodar initial dose of 100mg.d-1, sub-morning and evening oral, weekly increase of 50mg, the maximum dose of 300mg.d-1.2 group were treated 3 courses. Results: After three courses of treatment, the treatment group of 22 patients, partial remission in 12 cases, the total effective rate was 77.3%; control group of 20 patients, partial remission in 4 cases, the total effective rate was 55.0%, the difference was statistically significant (P <0.05). In the indexes of M-protein, bone marrow plasma cells and β2-microglobulin, there were significant differences between the two groups before treatment and the significant increase of hemoglobin in the two groups Obviously, the difference was statistically significant (P <0.05). After treatment, there were significant differences among the index groups (P <0.05). Conclusion: Compared with VAD alone, the combination of thalidomide and VAD is more effective in the treatment of multiple myeloma, with fewer side effects and better tolerability. It is worthy of clinical application.