【摘要】 目的:探讨硼替佐米联合地塞米松(BD)方案治疗多发性骨髓瘤(MM)前后血清Ⅰ型胶原交联氨基末端肽(NTX-Ⅰ)、护骨素(OPG)和血清骨特异性碱性磷酸酶(BALP)的变化及临床意义。方法:将28例MM患者随机分为BD组和VAD组,每组14例。BD组行BD方案化疗(硼替佐米+地塞米松),共6个周期。VAD组患者行VAD方案化疗(长春新碱+多柔比星+地塞米松),共6个周期。采用ELISA方法检测患者治疗前后血清NTX-Ⅰ、OPG和BALP水平,并选14名健康体检者作正常对照组。结果:BD组和VAD组MM患者治疗前血清NTX-Ⅰ较正常对照组显著升高,OPG和BALP水平较正常对照组均显著降低,两组之间差异无统计学意义,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NTX-Ⅰ、OPG和BALP水平与对照组比较,差异有统计学意义,P<0.05,BD组较VAD组变化更明显;两组治疗前后血清NTX-Ⅰ、OPG和BALP水平差异均有统计学意义,P<0.05。BD组总有效率明显高于VAD组,P<0.05。结论:MM患者血清NTX-Ⅰ水平较正常人显著升高,OPG和BALP水平较正常人显著降低,BD组治疗后总有效率高于VAD组,且BD组较VAD组治疗后血清NTX-Ⅰ水平下降更明显、OPG和BALP水平升高更明显,对改善MM患者骨代谢及预后有重要作用。更多还原

【Abstract】 OBJECTIVE: To explore the expressions and clinical significance of serum cross-linked N-telopeptides of type Ⅰ collagen(NTX-Ⅰ),osteoprotegerin(OPG),and bone alkaline phosphatase(BALP) in multiple myeloma(MM) patients treated with BD.METHODS: Tweety-eight patients with multiple myeloma were divided into two groups randomly,BD and VAD.Fourteen patients received six courses BD chemotherapy.The other group received six courses VAD chemotherapy.The expressions of NTX-Ⅰ,OPG and BALP were examined by ELISA assay before and after treatment and the results were compared with 14 normal persons as control group.RESULTS: All of the expressions of NTX-Ⅰ in MM patients was higher,and OPG and BALP were lower compared with normal persons before treatment.There were significant differences between treatment groups and control groups(P<0.01),but no significant difference was detected between two treatment groups(P>0.05).After treatment there was statistically difference in the expressions of NTX-Ⅰ.OPG and BALP between two treatment groups(P<0.05) and the data in group BD were significantly changed compared to the other,but both had statistically difference before and after treatment(P<0.05).The total effective rate was higher in group BD(P<0.05).CONCLUSIONS: The expression of NTX-Ⅰ is much higher,and the expressions of OPG and BALP are much lower in the patients with MM than those in the healthy people.The total effective rate after treatment is higher in group of BD than that in VAD,and the expressions of NTX-Ⅰ,OPG and BALP are significantly changed,which is clinically important for improving the prognosis of patients with MM.更多还原