目的 分析地塞米松聯(lián)合硼替佐米對老年多發(fā)性骨髓瘤的治療效果。方法 選擇2014年1月—2016年12月在宿州市市立醫(yī)院血液科進(jìn)行診治的41例老年多發(fā)性骨髓瘤患者，隨機(jī)分為兩組，觀察組21例，對照組20例。兩組均給予沙利度胺和環(huán)磷酰胺進(jìn)行治療，分別口服沙利度胺100 mg，1次/d，并分別于第1、8、15天靜滴環(huán)磷酰胺300 mg/m²。同時(shí)，對照組于第1~4天靜脈滴注地塞米松20 mg。觀察組在對照組基礎(chǔ)上皮下注射硼替佐米1.3 mg/m²，1次/周，1個(gè)療程為4周，2個(gè)療程后進(jìn)行綜合評價(jià)。比較兩組的臨床治療效果，檢測兩組治療前后的β2微球蛋白、骨髓瘤細(xì)胞以及免疫球蛋白水平及不良反應(yīng)。結(jié)果 觀察組的有效率為85.71%，明顯高于對照組的60.00%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后的β2微球蛋白、骨髓瘤細(xì)胞以及免疫球蛋白水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組明顯低于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組間各不良反應(yīng)的發(fā)生率無統(tǒng)計(jì)學(xué)差異，且各不良反應(yīng)通過停藥或給予相應(yīng)對癥處理后均可得到緩解。結(jié)論 地塞米松聯(lián)合硼替佐米治療老年多發(fā)性骨髓瘤的臨床效果明顯，可作為初治、難治或復(fù)發(fā)老年多發(fā)性骨髓瘤患者的一線治療方案。

Objective To investigate the clinical effect of dexamethasone combined with bortezomib in the treatment of multiple myeloma in the elderly.Methods Selected 41 cases of patients with multiple myeloma who were treated in our hospital from January 2014 to December 2016, divided into two groups randomly. Both groups were treated with thalidomide and cyclophosphamide, while the control group was treated with dexamethasone, which was treated with dexamethasone. The clinical therapeutic effects of the two groups were compared.Results After treatment, the effective rate of the observation group was 85.71% (18/21), significantly higher than that of the control group 60.00% (12/20) (P<0.05). The levels of beta 2 microglobulin, myeloma cells and immunoglobulin in the two groups were significantly decreased (P<0.05), and the observation group was significantly lower than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups, and all adverse reactions could be relieved by discontinuing the drug or giving appropriate symptomatic treatment. Conclusion The clinical effect of dexamethasone on the treatment of senile multiple myeloma is obvious and can be used as a firstline treatment for patients with multiple myeloma in the early treatment, refractory or relapse.