摘要
目的探讨含低剂量地塞米松的PAD方案对于多发性骨髓瘤的临床治疗效果以及安全性。方法选取2014年2月至2017年6月我院收治的初发性多发性骨髓瘤患者98例为研究对象,按随机数字表法分为常规组和观察组各49例。常规组患者给予含大剂量地塞米松(总量480mg/28d)的PAD治疗方案,观察组患者给予含低剂量地塞米松(总量160mg/28d)的PAD治疗方案。比较两组患者在治疗4个疗程后的临床治疗效果、免疫指标、实验室相关项目以及不良反应的发生率。结果治疗后两组患者免疫指标、实验室相关项目以及临床治疗效果比较,差异无统计学意义(P>0.05);两组患者在白细胞下降、血小板减少、贫血、心脏毒性等方面的不良反应的发生率,差异无统计学意义(P>0.05);观察组患者在高血糖、高血脂、高血压、肺炎、带状疱疹、低钾血症、胃溃疡、周围神经炎以及严重血栓事件等方面的不良反应的发生率等均明显低于常规组患者,差异有统计学意义(P<0.05)。结论含低剂量地塞米松的PAD方案治疗多发性骨髓瘤患者临床治疗效果确定,而毒性不良反应则大大降低,患者的耐受性良好,具有较高的安全性,值得临床推广应用。
Objective To investigate the clinical efficacy and safety of PAD regimen with low dose of dexamethasone in the treatment of multiple myeloma.Methods 98 patients with primary multiple myeloma treated in our hospital from February 2014 to June 2017 were selected and randomly divided into two groups:the routine group(n=49)and the observation group(n=49).The patients in the routine group were treated with PAD regimen with high dose of dexamethasone(480mg/28d),while the patients in the observation group were given PAD regimen with low dose of dexamethasone(160mg/28d).The clinical efficacy,immunological indexes,laboratory related items and the incidence of adverse reactions were compared between the two groups after 4 courses of treatment.Results There was no statistically significant difference in immunological indexes,laboratory related items and clinical effects between the two groups after treatment(P>0.05);No statistically significant difference in the incidence of adverse reactions like leukopenia,thrombocytopenia,anemia and cardiac toxicity between the two groups(P>0.05);The incidence of adverse reactions such as hyperglycemia,hyperlipidemia,hypertension,pneumonia,herpes zoster,hypokalemia,gastric ulcer,peripheral neuritis and severe thrombotic events in the observation group were significantly lower than those in the routine group(P<0.05).Conclusion The PAD regimen with low dose of dexamethasone is effective in the treatment of multiple myeloma patients,and the toxic adverse reactions are greatly reduced,patients with good tolerance and high safety,which is worthy of clinical application.
作者
曾昭宇
郑琳
陈蓉
王小渝
Zeng Zhaoyu;Zheng Lin;Chen Rong(Department of Hematology,The Third People′s Hospital of Chengdu,Chengdu,Sichuan 610031,China)
出处
《四川医学》
CAS
2018年第10期1140-1143,共4页
Sichuan Medical Journal
