地塞米松联合硼替佐米对老年多发性骨髓瘤的治疗效果

目的 分析地塞米松联合硼替佐米对老年多发性骨髓瘤的治疗效果。方法 选择2014年1月—2016年12月在宿州市市立医院血液科进行诊治的41例老年多发性骨髓瘤患者，随机分为两组，观察组21例，对照组20例。两组均给予沙利度胺和环磷酰胺进行治疗，分别口服沙利度胺100 mg，1次/d，并分别于第1、8、15天静滴环磷酰胺300 mg/m²。同时，对照组于第1~4天静脉滴注地塞米松20 mg。观察组在对照组基础上皮下注射硼替佐米1.3 mg/m²，1次/周，1个疗程为4周，2个疗程后进行综合评价。比较两组的临床治疗效果，检测两组治疗前后的β2微球蛋白、骨髓瘤细胞以及免疫球蛋白水平及不良反应。结果 观察组的有效率为85.71%，明显高于对照组的60.00%，差异有统计学意义（P<0.05）。两组治疗后的β2微球蛋白、骨髓瘤细胞以及免疫球蛋白水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显低于对照组，差异有统计学意义（P<0.05）。两组间各不良反应的发生率无统计学差异，且各不良反应通过停药或给予相应对症处理后均可得到缓解。结论 地塞米松联合硼替佐米治疗老年多发性骨髓瘤的临床效果明显，可作为初治、难治或复发老年多发性骨髓瘤患者的一线治疗方案。

Effect of dexamethasone combined with bortezomib in treatment of multiple myeloma in the elderly

Objective To investigate the clinical effect of dexamethasone combined with bortezomib in the treatment of multiple myeloma in the elderly.Methods Selected 41 cases of patients with multiple myeloma who were treated in our hospital from January 2014 to December 2016, divided into two groups randomly. Both groups were treated with thalidomide and cyclophosphamide, while the control group was treated with dexamethasone, which was treated with dexamethasone. The clinical therapeutic effects of the two groups were compared.Results After treatment, the effective rate of the observation group was 85.71% (18/21), significantly higher than that of the control group 60.00% (12/20) (P<0.05). The levels of beta 2 microglobulin, myeloma cells and immunoglobulin in the two groups were significantly decreased (P<0.05), and the observation group was significantly lower than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups, and all adverse reactions could be relieved by discontinuing the drug or giving appropriate symptomatic treatment. Conclusion The clinical effect of dexamethasone on the treatment of senile multiple myeloma is obvious and can be used as a firstline treatment for patients with multiple myeloma in the early treatment, refractory or relapse.