中国生化药物杂志
中國生化藥物雜誌
중국생화약물잡지
CHINESE JOURNAL OF BIOCHEMICAL PHARMACEUTICS
2015年
4期
138-140,143
,共4页
硼替佐米%地塞米松%多发性骨髓瘤%生化指标
硼替佐米%地塞米鬆%多髮性骨髓瘤%生化指標
붕체좌미%지새미송%다발성골수류%생화지표
bortezomib%dexamethasone%multiple myeloma%biochemical index
目的：探讨硼替佐米结合地塞米松对多发性骨髓瘤骨病的疗效及生化指标的影响。方法40例多发性骨髓瘤患者随机分为试验组20例和对照组20例，2组患者均给予唑来膦酸，试验组采用硼替佐米联合地塞米松治疗方案，对照组给予长春新碱＋地塞米松＋表柔比星方案；化疗3个疗程后比较2组患者骨痛缓解程度、临床疗效和不良反应发生率；并分析2组患者化疗前后血清钙、磷、Dickkopf相关蛋白1（recombinant human Dickkopf-related protein 1，DDK1）、核因子κB受体活化因子配体（receptor activator of nuclear factor kappa B ligand ，RANKL）、抗酒石酸酸性磷酸酶及碱性磷酸酶水平（ tartrate resistant acid phosphatase-5b，TRACP-5b）。结果2组患者化疗结束后骨痛程度均得到显著缓解，其中试验组骨痛改善程度显著优于对照组（ P＜0.05）。试验组总有效率为95.0％，显著高于对照组（65.0％），2组比较差异具有统计学意义（χ2＝5.652，P＝0.018）。2组各主要不良反应发生率比较差异无统计学意义。化疗后试验组血钙、磷、DDK1、RANKL、TRACP-5b水平显著低于对照组，ALP显著高于对照组（P＜0.05）。结论硼替佐米联合地塞米松能够显著提高多发性骨髓瘤骨病的疗效，其作用机制可能是通过抑制骨代谢调节因子DDK1、RANKL、TRACP-5b水平，调节溶骨和成骨过程平衡。
目的：探討硼替佐米結閤地塞米鬆對多髮性骨髓瘤骨病的療效及生化指標的影響。方法40例多髮性骨髓瘤患者隨機分為試驗組20例和對照組20例，2組患者均給予唑來膦痠，試驗組採用硼替佐米聯閤地塞米鬆治療方案，對照組給予長春新堿＋地塞米鬆＋錶柔比星方案；化療3箇療程後比較2組患者骨痛緩解程度、臨床療效和不良反應髮生率；併分析2組患者化療前後血清鈣、燐、Dickkopf相關蛋白1（recombinant human Dickkopf-related protein 1，DDK1）、覈因子κB受體活化因子配體（receptor activator of nuclear factor kappa B ligand ，RANKL）、抗酒石痠痠性燐痠酶及堿性燐痠酶水平（ tartrate resistant acid phosphatase-5b，TRACP-5b）。結果2組患者化療結束後骨痛程度均得到顯著緩解，其中試驗組骨痛改善程度顯著優于對照組（ P＜0.05）。試驗組總有效率為95.0％，顯著高于對照組（65.0％），2組比較差異具有統計學意義（χ2＝5.652，P＝0.018）。2組各主要不良反應髮生率比較差異無統計學意義。化療後試驗組血鈣、燐、DDK1、RANKL、TRACP-5b水平顯著低于對照組，ALP顯著高于對照組（P＜0.05）。結論硼替佐米聯閤地塞米鬆能夠顯著提高多髮性骨髓瘤骨病的療效，其作用機製可能是通過抑製骨代謝調節因子DDK1、RANKL、TRACP-5b水平，調節溶骨和成骨過程平衡。
목적：탐토붕체좌미결합지새미송대다발성골수류골병적료효급생화지표적영향。방법40례다발성골수류환자수궤분위시험조20례화대조조20례，2조환자균급여서래련산，시험조채용붕체좌미연합지새미송치료방안，대조조급여장춘신감＋지새미송＋표유비성방안；화료3개료정후비교2조환자골통완해정도、림상료효화불량반응발생솔；병분석2조환자화료전후혈청개、린、Dickkopf상관단백1（recombinant human Dickkopf-related protein 1，DDK1）、핵인자κB수체활화인자배체（receptor activator of nuclear factor kappa B ligand ，RANKL）、항주석산산성린산매급감성린산매수평（ tartrate resistant acid phosphatase-5b，TRACP-5b）。결과2조환자화료결속후골통정도균득도현저완해，기중시험조골통개선정도현저우우대조조（ P＜0.05）。시험조총유효솔위95.0％，현저고우대조조（65.0％），2조비교차이구유통계학의의（χ2＝5.652，P＝0.018）。2조각주요불량반응발생솔비교차이무통계학의의。화료후시험조혈개、린、DDK1、RANKL、TRACP-5b수평현저저우대조조，ALP현저고우대조조（P＜0.05）。결론붕체좌미연합지새미송능구현저제고다발성골수류골병적료효，기작용궤제가능시통과억제골대사조절인자DDK1、RANKL、TRACP-5b수평，조절용골화성골과정평형。
Objective To explore the clinical effect and biochemical index changes of bortezomib combined with dexamethasone in multiple myeloma bone disease.Methods A total of 40 cases of multiple myeloma patients were randomly divided into experimental group (20 cases) and control group (20 cases), two groups of patients were treated with zoledronic acid, the experiment group adopted the bortezomib and dexamethasone treatment scheme, control group received dexamethasone+vincristine+epirubicin scheme.After 3 courses of treatment,compared the pain relieving degree,clinical efficacy and adverse reactions incidence, and analysed serum calcium, phosphorus, DDK1, RANKL, TRACP-5b and ALP levels of two groups.Results After the end of chemotherapy,bone pain in two groups was significantly relieved,and the pain relieving degree experimental group was significantly better than the control group (P<0.05).Total effective rate in experimental group was 95.0%, significantly higher than that in control group 65.0%(χ2 =5.625,P=0.018).The adverse reaction rate had no significant difference between two groups.The of calcium, phosphorus after chemotherapy, DDK1, RANKL, TRACP-5b levels in experimental group were significantly lower than those in control group, ALP was significantly higher than that of control group (P<0.05).Conclusion Bortezomib in combination with dexamethasone can significantly improve the curative effect of multiple myeloma,and its mechanism may regulate DDK1, RANKL, TRACP-5b levels,and balance the osteolytic and osteoblastic process.
