Plasma exchange followed by chemotherapy treatment for multiple-myeloma patients with high viscosity syndrome and renal dysfunction: a clinical analysis
目的探讨血浆置换术(PE)序贯化疗对多发性骨髓瘤(MM)伴高黏滞综合征和肾功能损害患者的近期疗效。方法收集20例多发性骨髓瘤伴高黏滞综合征和不同程度肾功能损害病例,随机均分为PE联合化疗组(PE+化疗组):使用血细胞分离机行PE,置换3次/[(2 600±580)m L/次、间隔1 d]后序贯VAD方案(长春新碱0.5 mg持续静脉滴注12 h,阿霉素10 mg持续静脉滴注12 h,地塞米松40 mg qd1-4)化疗;单纯化疗组(对照组):患者接受标准VAD方案治疗。比较2组在2周期治疗前后的球蛋白(GLB)、血沉(ESR)、血液流变学指标等指标。结果高黏滞综合征相关症状龈血/鼻衄,头昏和肢端麻木,PE+化疗组较对照组有明显改善(P<0.05);治疗前及治疗后PE+化治疗组、对照组GLB(g/L)分别为80.0±19.6 vs 30.0+10.5,85.5±21.5 vs 53.5±16.0(P<0.05);Cr(μmol/L)分别为359.0±30.5 vs 105.0±25.0,362.0±39.6 vs 190.0±43.0(P<0.05);ESR(mm/h)分别为80.0±22.5 vs 12±0....
【英文摘要】
Objective To assess the clinical performance of plasma exchange( PE) followed by chemotherapy treatment for multiple-myeloma patients with high-viscosity syndrome and renal dysfunction.Methods 20 cases of multiple-myeloma patients with high viscous syndrome and various levels of renal dysfunction,were randomly divided into PE-chemotherapy group( the experiment groups) and chemotherapy-only group( the control group). In the experiment groups,the patients received PE via blood cell separators for 3 times( 2 6...
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