沙利度胺联合VAD治疗多发性骨髓瘤的血清VEGF变化

目的 探讨沙利度胺联合VAD方案治疗多发性骨髓瘤（multiple myeloma，MM）的临床疗效及治疗前后血管内皮生长因子（vascular endothelial growth factor，VEGF）水平变化。方法 28例MM患者，其中初治组14例，复发难治组14例，采用沙利度胺联合VAD方案治疗，在治疗前后测定每一例患者VEGF水平。结果 初治组14例：部分缓解10例，进步2例，总有效率85．7％，复发难治组14例，部分缓解6例，进步3例，总有效率64．3％。经检验差异有显著性（P〈0.05）。多发性骨髓瘤患者血清VEGF水平与疾病的活动情况相关，化疗有效者血清VEGF水平明显下降（P〈0．05），而化疗无效者则下降不明显（P〉0.05）。结论 沙利度胺联合VAD方案治疗多发性骨髓瘤具有副作用少，耐受性好，给药方便，疗效明显的优点，值得临床推广应用。

Clinical Study of Thalidomide Incorporation with VAD in Treatment of Multiple Myeloma with Emphasis on VEGF Change

Objective To study the curative effect and side effect of thalidomide incorporation with VAD in the treatment of multiple myeloma and the significance of the change of serum VEGF(vascular endothelial growth factor) concentration in multiple myeloma.Methods 28 multiple myeloma patients were divided into newly diagnosed and secondary refractory myeloma,and they were treated with VAD plus thalidomide and the serum VEGF concentration of 28 patients were detected by ELISA.Results The efficacy rate were 85.7% and 64.3% in the newly diagnosed and secondary refractory myeloma respectively.Serum VEGF concentration in MM was related to the clinical change(P<0.05).Conclusion()()Thalidomide incorporation with VAD applied in multiple myeloma has merits such as less side effects,good tolerance,convention administration and significant curative effect,it is proved to be valuable and proposed to be popularized in clinical use.