疏血通注射液联合美法仑与泼尼松治疗多发性骨髓瘤的效果分析

摘要

Objective To observe the therapeutic effect of Shuxuetong injection combined with chemotherapy regimen of melphalan and prednisolone (MP) in treating multiple myeloma (MM).Methods Totally 72 patients with MM from Feburary 2010 to October 2013 were enrolled and randomly divided into MP group (36 cases) receiving MP chemotherapy regimen and Shuxuetong ± MP group (36 cases) receiving Shuxuetong (6 ml added to 250 ml 5％ glucose solution,1 time/d) on the basis of MP regimen.Each course of treatment consisted of 7 days with an interval of 28 days between two courses,and the treatment last for 6 courses.Before treatment and after 3-6 courses,the blood viscosity,renal function,marrow cell morphology,serum calcium and β2 microglobulin were measured and compared between the two groups.Results After 6 courses,the Shuxuetong ± MP group had lower blood high shear viscosity,blood low shear viscosity,plasma viscosity,hematocrits,erythrocyte aggregation index,red cell rigidity index,β2 microglobulin,myeloma cell percentage,actate dehydrogenase,urea nitrogen and serum creatinine,higher erythrocyte deformation index and higher hemoglobin compared with those in control group [(5.1 ±0.5) mPa/s vs (6.8 ±0.6) mPa/s,(10.6 ± 1.6) mPa/s vs (13.6 ± 1.3) mPa/s,(1.63 ±0.16) mPa/s vs (2.16 ±0.21) mPa/s,(0.38 ±0.04)％ vs (0.48 ±0.05)％,(6.6 ± 0.6) vs (8.5±0.8),(5.8±0.6)vs (6.5±0.6),(1 689 ±172)μg/L vs (3 875±395) μg/L,(1.21 ± 0.14)％ vs (12.47 ±1.48)％,(130 ±14) U/L vs (215 ±20) U/L,(5.1 ±0.5) mmol/L vs (6.8 ± 0.6) mmol/L,(10.6±1.6) mmol/L vs (13.6±1.3) mmol/L,(2.85 ±0.28) vs (2.18 ±0.11),(119 ± 11) g/L vs (90 ±9) g/L] (P ＜0.05).Conclusion Shuxuetong injection combined with MP chemotherapy regimen can reduce the blood viscosity and improve renal function in patients with MM.%目的 探讨疏血通注射液与美法仑联合泼尼松(MP)方案联合治疗多发性骨髓瘤患者的效果.方法 选取2010年2月至2013年10月重庆三峡中心医院血液科收治的72例初诊多发性骨髓瘤患者为研究对象,将患者完全随机分为MP组和疏血通联合MP组,各36例.MP组使用MP方案进行化疗;疏血通联合MP组在MP组基础上,将6ml疏血通注射液加入250 ml 5％葡萄糖溶液中静脉滴注,1次/d.2组均7d为1个疗程,间隔28 d开始下一个疗程,共治疗6个疗程.比较2组患者治疗前及治疗3、6个疗程后血黏度、肾功能、骨髓形态、血钙和β2微球蛋白等水平.结果 治疗6个疗程后,疏血通联合MP组全血高切黏度、全血低切黏度、血浆黏度、血细胞比容、红细胞集聚指数、红细胞刚性指数、β2微球蛋白、骨髓瘤细胞百分比、乳酸脱氢酶、尿素氮与肌酐均低于MP组,红细胞变形指数、血红蛋白高于MP组[(5.1 ±0.5)mPa/s比(6.8±0.6) mPa/s、(10.6±1.6) mPa/s比(13.6±1.3) mPa/s、(1.63±0.16) mPa/s比(2.16±0.21) mPa/s、(0.38±0.04)％比(0.48±0.05)％、(6.6±0.6)比(8.5±0.8)、(5.8±0.6)比(6.5±0.6)、(1 689±172) μg/L比(3 875±395) μg/L、(1.21±0.14)％比(12.47±1.48)％、(130±14) U/L比(215±20) U/L、(5.1±0.5)mmol/L比(6.8±0.6)mmol/L、(10.6±1.6) mmol/L比(13.6±1.3) mmol/L、(2.85±0.28)比(2.18±0.11)、(119±11)g/L比(90±9)g/L],差异均有统计学意义(均P＜0.05).结论 疏血通注射液与MP方案联合应用可降低多发性骨髓瘤患者血黏度,改善肾功能.