内科

目的探讨地塞米松联合硼替佐米治疗多发性骨髓瘤（MM）患者的临床效果及对患者骨代谢、免疫功能的影响。方法选取2017年1月至2020年4月我院收治的MM患者100例为研究对象，利用随机数字法将患者分为试验组与对照组，每组50例。对照组患者采用环磷酰胺、沙利度胺、地塞米松化疗方案治疗，试验组患者采用地塞米松联合硼替佐米化疗方案治疗，治疗6个疗程。比较两组患者的临床治疗效果；比较两组患者治疗前后的骨代谢状况及免疫功能。结果治疗6个疗程，试验组患者的治疗总有效率（80.0%）高于对照组（54.0%），差异有统计学意义（P＜0.05）。治疗前，两组患者的血清骨钙素（OCN）、Ⅰ型胶原C末端肽（CTX-Ⅰ）水平比较，差异无统计学意义（P＞0.05）；治疗6个疗程后，试验组患者的OCN水平显著高于对照组，CTX-1水平显著低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的CD4+、CD8+、CD4+/CD8+水平比较，差异无统计学意义（P＞0.05）；治疗6个疗程后，试验组患者的CD4+、CD4+/CD8+水平显著高于对照组，CD8+水平显著低于对照组，差异有统计学意义（P＜0.05）。结论应用地塞米松联合硼替佐米化疗方案治疗多发性骨髓瘤患者可取得满意的临床效果，能够显著改善患者的骨代谢情况，提高患者的免疫功能，值得推广应用。

ObjectiveTo investigate the clinical effect of dexamethasone combined with bortezomib in the treatment of multiple myeloma (MM) patients and its effect on bone metabolism and immune function. MethodsA total of 100 MM patients admitted to our hospital between January 2017 and April 2020 were enrolled as the research objects, and they were divided into experimental group and control group by the random number method, with 50 cases in each group. The control group was treated with cyclophosphamide, thalidomide and dexamethasone chemotherapy for 6 months, while the experimental group was treated with the chemotherapy of dexamethasone combined with bortezomib for 6 months. The clinical therapeutic effects of the two groups was compared. Bone metabolism and immune function were compared between the two groups before and after treatment. ResultsAfter 6 treatment courses, the total effective rate of the experimental group (80.00%) was higher than that of the control group (54.0%) , and the difference was statistically significant (P＜0.05). Before treatment, there were no statistically significant differences in serum osteocalcin (OCN) and C-terminal telopeptide of type Ⅰ collagen (CTX-Ⅰ) levels between the two groups (P＞0.05). After 6 courses of treatment, the OCN level of the experimental group was significantly higher than that of the control group, while CTX-Ⅰ level was remarkably lower than that of the control group,and the difference was statistically significant (P＜0.05). Before treatment, there were no statistically significant differences in CD4+, CD8+ and CD4+/CD8+ levels between both groups. After 6 courses of treatment, the levels of CD4+ and CD4+/CD8+ in the experimental group were significantly higher than those in the control group, while the level of CD8+ was lower than that in the control group, with statistically significant differences (P＜0.05). ConclusionThe chemotherapy of dexamethasone combined with bortezomib in the treatment of patients with MM can achieve satisfactory clinical effect, significantly improve the bone metabolism and the immune function of patients, which is worthy of promotion and popularization.