沙利度胺联合环磷酰胺与地塞米松治疗复发难治多发性骨髓瘤

摘要

目的：观察并研究沙利度胺联合环磷酰胺与地塞米松治疗复发难治多发性骨髓瘤的临床疗效。方法：选取2013年7月-2015年6月本院接诊的复发难治多发性骨髓瘤患者50例，按照随机数字表法分为对照组（硼替佐米联合地塞米松）与观察组（沙利度胺联合环磷酰胺与地塞米松），各25例，对比两组的治疗效果和安全性。结果：观察组治疗总有效率为84.00%，与对照组相比差异无统计学意义（χ²=2.58，P>0.05）；观察组不良反应发生率为12.00%，较对照组相对更低，差异有统计学意义（χ²=4.32，P<0.05），对所有不良反应患者进行对症处理后均恢复良好；观察组肾功能恢复时间和治疗时间分别为（18.49±3.20）、（32.19±6.59）d，均显著低于对照组，差异均有统计学意义（t=14.58、18.90， P<0.05）；观察组医疗费用明显低于对照组（t=13.16，P<0.05）。结论：沙利度胺联合环磷酰胺与地塞米松治疗复发难治多发性骨髓瘤临床效果确切，可显著改善患者的有关症状，且在治疗过程中不会发生明显的不良反应，安全性高，医疗费用相对更低，具备临床上推广应用的意义与价值。%Objective:To observe and study the clinical efficacy of Thalidomide combined with Cyclophosphamide and Dexamethasone in the treatment of recurrent refractory multiple myeloma.Method:From July 2013 and 2015 June in our hospital admissions difficult Zhido hair myeloma patients 50 cases,they were randomly divided into the control group(Bortezomib combined with Dexamethasone) and the observation group (Thalidomide combined with Cyclophosphamide and Dexamethasone),25 cases in each group,clinical effects and safety of two groups were compared.Result:The total efficiency rate of the observation group was 84.00%,compared with the control group,there was no statistical significance( χ²=2.58,P>0.05).The adverse reaction rate of the observation group was 12.00%,compared with the control group,there was statistical significance( χ²=4.32, P<0.05),all adverse reactions of patients were symptomatic treatment after a good recovery.The renal function recovery time and treatment time of the observation group were (18.49±3.20),(32.19±6.59)d,they were significantly lower than those of the control group(t=14.58,18.90,P<0.05).Medical cost of the observation group was lower than that of the control group(t=13.16,P<0.05).Conclusion:Thalidomide combined with Cyclophosphamide and Dexamethasonein the treatmeng of Relapsed refractory multiple myeloma have a clinical curative effect,can significantly improve the patient's symptoms,and in the course of treatment do not occur obvious adverse reaction, high security,with significance and value in clinical application.