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目的 :探讨改良的硼替佐米联合方案治疗多发性骨髓瘤患者的临床价值。方法 :选取我院2010年4月~2016年4月多发性骨髓瘤患者共60例,其中改良组28例采用改良的硼替佐米联合化疗方案,常规组32例采用硼替佐米常规方案治疗,观察其疗效和不良反应。结果 :随访3~48(平均23)个月后,改良组有效率为78.6%,与对照组有效率78.1%比较差异无统计学意义。硼替佐米不良反应主要包括周围神经病变(PN)、血小板减少、粒细胞减少、疱疹、肺部感染、胃肠道反应等。改良组PN发生率10.7%,明显低于对照组PN发生率31.3%,其它不良反应发生率无明显差异。对照组1例因肺部严重感染抢救无效死亡,观察组无死亡病例。结论 :多发性骨髓瘤患者采用改良的硼替佐米联合方案不影响疗效,且不良反应少,安全性更高,患者耐受性更好。
Objective: To investigate the clinical value of modified bortezomib in the treatment of patients with multiple myeloma. Methods: A total of 60 patients with multiple myeloma were selected from April 2010 to April 2016 in our hospital. Among them, 28 patients in the modified group received modified bortezomib plus chemotherapy, and 32 patients in the conventional group received conventional bortezomib regimen. Observe its efficacy and adverse reactions. Results: After 3 ~ 48 months (mean 23) months of follow-up, the effective rate of the modified group was 78.6%, which was not significantly different from that of the control group (78.1%). Bortezomib adverse reactions mainly include peripheral neuropathy (PN), thrombocytopenia, neutropenia, herpes, lung infections, gastrointestinal reactions. The incidence of PN in the modified group was 10.7%, which was significantly lower than that in the control group (31.3%). There was no significant difference in other adverse reactions. In the control group, one patient died of severe pulmonary infection and died without any deaths in the observation group. Conclusions: The improved bortezomib regimen in patients with multiple myeloma does not affect the efficacy and has fewer adverse reactions, higher safety and better patient tolerability.