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双膦酸盐与传统化疗联合应用对多发性骨髓瘤患者骨代谢标志物的影响。

The effect of the combination of bisphosphonates and conventional chemotherapy on bone metabolic markers in multiple myeloma patients.

作者信息

Zhang Xi, Chang Chunkang, Zhao Youshan, Wu Lingyun, Zhang Zheng, Li Xiao

机构信息

Shanghai Sixth People's Hospital, Shanghai, China.

出版信息

Hematology. 2012 Sep;17(5):255-60. doi: 10.1179/1607845412Y.0000000021.

Abstract

PURPOSE

Urinary N-terminal telopeptides of type I collagen (uNTX), serum bone alkaline phosphatase (sBAP) have been acknowledged in observing bone metastases of solid tumors. The paper is designed to study the value of clinical application of uNTX and sBAP in the treatment of multiple myeloma (MM), as well as the action of bisphosphonates for osteolytic bone lesion.

METHODOLOGY

Thirty-three MM cases were treated with bisphosphonates (hereinafter called clodronate therapy group) and 20 MM cases were treated with simple chemotherapy (hereinafter called control group). uNTX and sBAP were tested during the courses of treatment three times (pretreatment, 3 months, and 6 months). uNTX was tested by enzyme-linked immunosorbent assay. sBAP was tested by chemiluminescence analysis. All the results were analyzed with t-test by using SPSS 11.0.

RESULTS

There were no significant differences between therapy and control groups: in uNTX (173.74 ± 14.55) and (129.79 ± 12.13) μg/l before treatment (P > 0.05). After 6 months there were significant differences between them: (85.71 ± 8.23) and (121.59 ± 12.43) μg/l (P < 0.05). And also there were significant differences among the courses in the therapy group. There were no significant differences between therapy and control groups in sBAP concentration: (4.78 ± 0.55) and (8.42 ± 1.32) μg/l before treatment (P > 0.05). After 6 months there were significant differences between them: (16.01 ± 0.52) and (9.62 ± 1.29) μg/l (P < 0.001). And also there were significant differences among the courses in the therapy group.

CONCLUSION

uNTX and sBAP were important to measure the situation of the osteolytic bone lesion in MM. Bisphosphonates can significantly reduce bone degradation and metabolism, improve the synthesis, which is valuable for the treatment of MM cases.

摘要

目的

I型胶原的尿N末端肽(uNTX)、血清骨碱性磷酸酶(sBAP)在实体瘤骨转移观察中已得到认可。本文旨在研究uNTX和sBAP在多发性骨髓瘤(MM)治疗中的临床应用价值,以及双膦酸盐对溶骨性骨病变的作用。

方法

33例MM患者接受双膦酸盐治疗(以下简称氯膦酸盐治疗组),20例MM患者接受单纯化疗(以下简称对照组)。在治疗过程中对uNTX和sBAP进行3次检测(治疗前、3个月和6个月)。uNTX采用酶联免疫吸附测定法检测。sBAP采用化学发光分析法检测。所有结果用SPSS 11.0软件进行t检验分析。

结果

治疗组与对照组治疗前uNTX分别为(173.74±14.55)和(129.79±12.13)μg/l,差异无统计学意义(P>0.05)。6个月后,两组差异有统计学意义:分别为(85.71±8.23)和(121.59±12.43)μg/l(P<0.05)。治疗组各疗程间差异也有统计学意义。治疗组与对照组治疗前sBAP浓度分别为(4.78±0.55)和(8.42±1.32)μg/l,差异无统计学意义(P>0.05)。6个月后,两组差异有统计学意义:分别为(16.01±0.52)和(9.62±1.29)μg/l(P<0.001)。治疗组各疗程间差异也有统计学意义。

结论

uNTX和sBAP对评估MM患者溶骨性骨病变情况具有重要意义。双膦酸盐可显著降低骨降解和代谢,促进合成,对MM患者的治疗具有重要价值。

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