CAJ | 학술논문

目的：观察环磷酰胺联合VAD化学治疗（简称化疗）方案治疗多发性骨髓瘤（MM）的临床疗效及其X线摄片特点。方法回顾性分析医院2009年至2012年收治的148例MM患者的临床资料，总结X线摄片的诊断特点，并根据治疗方案分为联合组（环磷酰胺+VAD，78例）和对照组（VAD，70例），比较两组患者治疗6个周期后的临床疗效及不良反应发生情况。结果148例MM患者中，头颅平片阳性率最高，与其他体位比较有显著性差异（χ2=142.936，P＜0.05）。治疗6个周期后，联合组的病灶缩小率为47.44%，显著高于对照组的31.43%（ P＜0.05）；联合组的病灶扩大率为14.10%，显著低于对照组的30.00%（ P＜0.05）；两组间的病灶消失率、病灶稳定率比较，差异无统计学意义（ P＞0.05）；联合组的总有效率为74.36%，显著高于对照组的54.29%（ P＜0.05）；联合组的不良反应发生率为69.23%，与对照组的61.43%比较无显著性差异（ P＞0.05）。结论 MM患者的X线摄片表现具有典型特征，头颅阳性率较高；环磷酰胺联合VAD化疗方案临床疗效更好，且不会增加不良反应的发生，值得临床推广。
목적：관찰배린선알연합VAD화학치료（간칭화료）방안치료다발성골수류（MM）적림상료효급기X선섭편특점。방법회고성분석의원2009년지2012년수치적148례MM환자적림상자료，총결X선섭편적진단특점，병근거치료방안분위연합조（배린선알+VAD，78례）화대조조（VAD，70례），비교량조환자치료6개주기후적림상료효급불량반응발생정황。결과148례MM환자중，두로평편양성솔최고，여기타체위비교유현저성차이（χ2=142.936，P＜0.05）。치료6개주기후，연합조적병조축소솔위47.44%，현저고우대조조적31.43%（ P＜0.05）；연합조적병조확대솔위14.10%，현저저우대조조적30.00%（ P＜0.05）；량조간적병조소실솔、병조은정솔비교，차이무통계학의의（ P＞0.05）；연합조적총유효솔위74.36%，현저고우대조조적54.29%（ P＜0.05）；연합조적불량반응발생솔위69.23%，여대조조적61.43%비교무현저성차이（ P＞0.05）。결론 MM환자적X선섭편표현구유전형특정，두로양성솔교고；배린선알연합VAD화료방안림상료효경호，차불회증가불량반응적발생，치득림상추엄。
Objective To observe the clinical effect and X-ray radiography characteristic of cyclophosphamide combined with the VAD chemotherapy regimen for treating multiple myeloma(MM). Methods The clinical data in 148 cases of MM in our hospital from 2009 to 2012 were analyzed retrospectively. The characteristics of X-ray radiography in MM were summarized. The patients were divided into the combined group (cyclophosphamide + VAD,78 cases) and the control group (VAD,70 cases) according to the treatment re-gimens. The differences in the clinical effects and adverse reactions after 6-cycle treatment were compared between the two groups. Results In 148 cases of MM,the positive rate was highest in head plain film,showing significant differences compared with other positions (χ2=142. 936,P < 0. 05). The lesion minification rate after 6-cycle therapy in the combined group was 47. 44%, which was significantly higher than 31. 43% in the control group( P < 0. 05),the lesion expansion rate in the combined group was 14. 10%,which was significantly lower than 30. 00% in the control group( P < 0. 05);the lesion disappearance rate and lesion stability rate had no statistically significant differences between the two groups( P > 0. 05);the total effective rate in the combined group was 74. 36% ,which was significantly higher than 54. 29% in control group( P < 0. 05). The incidence rate of adverse reactions was 69. 23% in the combined group and 61. 43% in the control group,but the difference was not statistically significant( P > 0. 05). Conclusion The X-ray image manifestations of MM have typical characteristics,and the positive rate is higher in the skull;cy-clophosphamide combined with VAD chemotherapy regimen has better effect without increasing the occurrence of adverse reactions and deserves in clinical promotion.