【摘要】 目的:探讨血清血管内皮生长因子(VEGF)、肿瘤坏死因子α(TNF-α)及白细胞介素-6(IL-6)在沙利度胺联合VAD方案化疗的多发性骨髓瘤(MM)患者中的表达及临床意义。方法:将46例MM患者随机分为T-VAD组(23例)和VAD组(23例),T-VAD组患者应用VAD方案同时连续口服沙利度胺200～250mg/d联合化疗,共6个周期。VAD组患者行VAD方案化疗,共6个周期。用ELISA方法检测患者治疗前后血清VEGF、TNF-α和IL-6水平。并以26例健康人作正常对照组。结果:VAD组和T-VAD组患者治疗前血清VEGF、TNF-α和IL-6水平较正常对照组均显著升高,两组差异无统计学意义(P>0.05),与正常对照组比较差异有统计学意义,P<0.01;治疗后两组患者血清VEGF、TNF-α和IL-6水平对照差异有统计学意义(P<0.05),T-VAD组较VAD组下降更明显;两组治疗前后VEGF、TNF-α和IL-6水平差异均有统计学意义,P<0.05。T-VAD组总有效率明显高于VAD组,P<0.05。结论:MM患者血清VEGF、TNF-α和IL-6水平较正常人明显升高,T-VAD组治疗后总有效率明显高于VAD组,且T-VAD组较VAD组治疗后血清VEGF、TNF-α和IL-6水平下降更明显,对改善多发性骨髓瘤患者预后有重要作用。更多还原

【Abstract】 OBJECTIVE: To explore the expressions and clinical significance of serum vascular endothelial growth factor(VEGF),tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in multiple myeloma(MM) patients with thalidomide and VAD chemotherapy.METHODS: Totally 46 patients were divided into two groups randomly,T-VAD and VAD.Twenty-three patients received six courses VAD chemotherapy and thalidomide 200-250 mg/d was taken orally every day.The other group received six VAD chemotherapy only.The expressions of VEGF,TNF-α and IL-6 were examined by ELISA before and after treatment,and compared with 26 normal persons as control group.RESULTS: Both the expressions of VEGF,TNF-α and IL-6 were higher compared with normal persons before treatment.There were significant differences between treatment groups and controls(P<0.01),but no significant difference was detected between both treatment groups(P>0.05).And after treatment,the difference was statistically different in the expressions of VEGF,TNF-α and IL-6 between two treatment groups(P<0.05),while the data of group T-VAD was significantly decreased than the other.But both had statistically difference before and after treatment(P<0.05).The total effective rate was higher in group T-VAD(P<0.05).CONCLUSIONS: The expressions of VEGF,TNF-α and IL-6 are much higher in the patients with MM than in the healthy people.The total effective rate after treatment is higher in group T-VAD than VAD,and the expressions of VEGF,TNF-α and IL-6 were significantly decreased,which is clinically important for improving the prognosis of patients with MM.更多还原