目的:探讨硼替佐米联合地塞米松(BD)方案治疗多发性骨髓瘤(MM)前后血清Ⅰ型胶原交联氨基末端肽(NTX-Ⅰ)、护骨素(OPG)和血清骨特异性碱性磷酸酶(BALP)的变化及临床意义。方法:将28例MM患者随机分为BD组和VAD组,每组14例。BD组行BD方案化疗(硼替佐米+地塞米松),共6个周期。VAD组患者行VAD方案化疗(长春新碱+多柔比星+地塞米松),共6个周期。采用ELISA方法检测患者治疗前后血清NTX-Ⅰ、OPG和BALP水平,并选14名健康体检者作正常对照组。结果:BD组和VAD组MM患者治疗前血清NTX-Ⅰ较正常对照组显著升高,OPG和BALP水平较正常对照组均显著降低,两组之间差异无统计学意义,P>0.05,与正常对照组比较差异有统计学意义,P<0.01;治疗后两组患者血清NTX-Ⅰ、OPG和BALP水平与对照组比较,差异有统计学意义,P<0.05,BD组较VAD组变化更明显;两组治疗前后血清NTX-Ⅰ、OPG和BALP水平差异均有统计学意义,P<0.05。BD组总有效率明显高于VAD组,P<0.05。结论:MM患者血清NTX-Ⅰ水平较正常人显著升高,OPG和BALP水平较正常人显著降低,BD组治疗后总有效率高于VAD组,且BD组较VAD组治疗后血清NTX-Ⅰ水平下降更明显、OPG和BALP水平升高更明显,对改善MM患者骨代谢及预后有重要作用。 Objective: To investigate the effects of bortezomib combined with dexamethasone (BD) on serum levels of type Ⅰ collagen cross-linked amino-terminal peptide (NTX-Ⅰ), osteoprotegerin (OPG) and serum-specific bone in the treatment of multiple myeloma (MM) Changes of the phosphatase (BALP) and its clinical significance. Methods: 28 MM patients were randomly divided into BD group and VAD group, 14 cases in each group. BD group chemotherapy regimen BD (bortezomib + dexamethasone), a total of 6 cycles. VAD patients underwent VAD chemotherapy (vincristine + doxorubicin + dexamethasone) for a total of 6 cycles. Serum levels of NTX-I, OPG and BALP were measured by ELISA before and after treatment, and 14 healthy subjects were selected as normal control group. Results: Compared with normal control group, serum NTX-Ⅰ levels in patients with BD and VAD before treatment were significantly higher than those in normal control group, but OPG and BALP levels were significantly lower than those in normal control group. There was no significant difference between the two groups (P> 0.05) Compared with the control group, the levels of serum NTX-I, OPG and BALP in the two groups were significantly different (P <0.05, P <0.05), the change of BDX group was more than that of VAD group Significantly, the levels of serum NTX-I, OPG and BALP in both groups before and after treatment were significantly different (P <0.05). The total effective rate of BD group was significantly higher than VAD group, P <0.05. CONCLUSION: The serum NTX-Ⅰ level in patients with MM is significantly higher than that in normal subjects, while the levels of OPG and BALP are significantly lower than those in normal subjects. The total effective rate in patients with BD is higher than that in patients with VAD. The level of decline more obvious, OPG and BALP levels increased more obvious, to improve the bone metabolism in MM patients and prognosis have an important role.