中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
3期
394-397
,共4页
王祥民%张姣丽%季国%石培民
王祥民%張姣麗%季國%石培民
왕상민%장교려%계국%석배민
多发性骨髓瘤%抗坏血酸%亚砷酸
多髮性骨髓瘤%抗壞血痠%亞砷痠
다발성골수류%항배혈산%아신산
Multiple myeloma%Ascorbic acid%Arsenic trioxide
目的：探讨亚砷酸联合维生素 C 对复发难治性多发性骨髓瘤的疗效，并与单用亚砷酸治疗进行比较。方法将2008至2011年收治的42例复发难治性多发性骨髓瘤患者随机分为两组：单用亚砷酸组（对照组）、亚砷酸联合维生素 C 组（联合组），每组患者21例。对照组予亚砷酸10 mg/d静脉滴注，6周一个疗程，其中前4周用药，间歇2周，共5个疗程；联合组在亚砷酸应用过程中加用维生素C 1.0 g/d静脉滴注，余同对照组。所有患者于疗程间歇期口服沙利度胺100 mg/d。结果（1）联合组患者总有效率63%，明显高于对照组（29%）（P＝0.043）。（2）联合组患者中位无进展生存期（PFS）为9.0个月（6.2～11.8个月），Kaplan-Meier法分析联合组PFS长于对照组（P＝0.043）；联合组中位总生存期（OS）为14.0个月（11.4～16.6个月），Kaplan-Meier法分析联合组 OS 长于对照组（P＝0.038）。（3）联合组各种不良反应与对照组比较均无显著差异（P＞0.05）。结论亚砷酸联合维生素C治疗复发难治性多发性骨髓瘤的疗效优于单用亚砷酸。
目的：探討亞砷痠聯閤維生素 C 對複髮難治性多髮性骨髓瘤的療效，併與單用亞砷痠治療進行比較。方法將2008至2011年收治的42例複髮難治性多髮性骨髓瘤患者隨機分為兩組：單用亞砷痠組（對照組）、亞砷痠聯閤維生素 C 組（聯閤組），每組患者21例。對照組予亞砷痠10 mg/d靜脈滴註，6週一箇療程，其中前4週用藥，間歇2週，共5箇療程；聯閤組在亞砷痠應用過程中加用維生素C 1.0 g/d靜脈滴註，餘同對照組。所有患者于療程間歇期口服沙利度胺100 mg/d。結果（1）聯閤組患者總有效率63%，明顯高于對照組（29%）（P＝0.043）。（2）聯閤組患者中位無進展生存期（PFS）為9.0箇月（6.2～11.8箇月），Kaplan-Meier法分析聯閤組PFS長于對照組（P＝0.043）；聯閤組中位總生存期（OS）為14.0箇月（11.4～16.6箇月），Kaplan-Meier法分析聯閤組 OS 長于對照組（P＝0.038）。（3）聯閤組各種不良反應與對照組比較均無顯著差異（P＞0.05）。結論亞砷痠聯閤維生素C治療複髮難治性多髮性骨髓瘤的療效優于單用亞砷痠。
목적：탐토아신산연합유생소 C 대복발난치성다발성골수류적료효，병여단용아신산치료진행비교。방법장2008지2011년수치적42례복발난치성다발성골수류환자수궤분위량조：단용아신산조（대조조）、아신산연합유생소 C 조（연합조），매조환자21례。대조조여아신산10 mg/d정맥적주，6주일개료정，기중전4주용약，간헐2주，공5개료정；연합조재아신산응용과정중가용유생소C 1.0 g/d정맥적주，여동대조조。소유환자우료정간헐기구복사리도알100 mg/d。결과（1）연합조환자총유효솔63%，명현고우대조조（29%）（P＝0.043）。（2）연합조환자중위무진전생존기（PFS）위9.0개월（6.2～11.8개월），Kaplan-Meier법분석연합조PFS장우대조조（P＝0.043）；연합조중위총생존기（OS）위14.0개월（11.4～16.6개월），Kaplan-Meier법분석연합조 OS 장우대조조（P＝0.038）。（3）연합조각충불량반응여대조조비교균무현저차이（P＞0.05）。결론아신산연합유생소C치료복발난치성다발성골수류적료효우우단용아신산。
Objective To investigate the curative effect with the combination therapy of Arsenic Trioxide and Ascorbic Acid in relapsed and refractory multiple myeloma. Methods 42 patients of relapsed and refractory multiple myeloma hospitalized during 2008 and 2011 were enrolled, and randomly divided into two groups: arsenic trioxide intervention group(control group)and arsenic trioxide combine with ascorbic acid intervention group(combination group), with each group 21 patients. The control group were given arsenic trioxide 10 mg/d intrave-nously daily. Each cycle was 6 weeks in duration, comprising 4 weeks of therapy followed by 2 weeks of intermission;while the combination group received ascorbic acid 1.0 g/d intravenously daily during the treatment time of arsenic trioxide in addition to the treatment of the control group. All patients received thalidomide 100 mg/d orally during the treatment intermission. Results (1) The combination group's overall response was 63%, which was much higher than the control group(29%)(P=0.043). (2) Kaplan-Meier statistical analysis showed that the median progression-free survival of the combination group was 9.0 months(range 6.2-11.8 months), which was longer than the control group(P=0.043). The median overall survival of the combination group was 14.0 months(range 11.4-16.6 months), which was also longer than the control group(P=0.038). (3) No significant difference was found between the two groups when referred to the adverse events(P>0.05). Conclusion Compared with the control group, the combination therapy of arsenic Trioxide and ascorbic acid acquired better curative effect in relapsed and refractory multiple myeloma patients.
