Objective To observe the curative effect of blood purification assisted multiple myeloma nephropathy and its effect on serum creatinine, blood uric acid.Methods A total of 74 cases of multiple myeloma nephropathy patients treated in hospital from June 2009 to June 2015 were selected as research subjects, according to the random number table method, they were divided into observation group 37 cases and control group 37 cases, the control group was chemotherapy with VAD regimen, observation group with blood purification treatment, after renal function improvement combined with VAD chemother-apy.Two groups of patients treated 4 weeks for 1 course, continuous treatment for 3 courses evaluation clinical efficacy.The recently clinical efficacy, serum creatinine, serum calcium, serum uric acid level, immune globulin, light chain protein levels and adverse reactions occur and survival of 3 years were compared between two groups.Results The observation group in the total efficiency was 78.4% (29 /37), which was higher than that of the control group 56.8% (21 /37), (χ2 =3.947, P =0.047); in observation group, serum creatinine, uric acid, calcium, light chain protein level was significantly lower than the control group ( t =19.081, t =1.979, t =5.877, t =2.205, P =0.000, P =0.025, P =0.000, P =0.015), and no sig-nificant changes in serum immunoglobulins ( t =1.492, P =0.069).Nausea /vomiting, abdominal distension, constipa-tion, dry mouth, poor appetite, poor sleep, bone marrow suppression, cardiac toxicity and other adverse symptoms occurred in 2 patients during chemotherapy, 2 groups of patients the adverse reaction rate comparison, there were no significant differences ( P >0.05).Follow up for 10 -36 months in 2 groups after a median follow-up of 21.7 months; the observation group 3 years survival rate was 40.5%, control group 3 years survival rate was 37.8%, the comparison between the 2 groups, the difference was not statistically significant (χ2 =0.153, P =0.696).Conclusion Chemotherapy combined with blood purifi-cation treatment of multiple myeloma kidney disease with renal insufficiency patients can effectively improve the microcircula-tion, be conducive to improve the clinical effect of chemotherapy, safe and effective, worthy of clinical application.%目的：观察血液净化辅治多发性骨髓瘤肾病的疗效及其对血肌酐、血尿酸的影响。方法选择2009年6月—2015年6月四川省绵阳市中医医院内四科收治的多发性骨髓瘤肾病患者74例作为研究对象，按照随机数字表法分为观察组37例和对照组37例。对照组采用 VAD 方案化疗；观察组进行血液净化治疗，改善肾功能后联合VAD 方案化疗；2组患者4周为1疗程，连续治疗3个疗程进行疗效评价。比较2组患者的近期临床疗效，血清肌酐、尿酸、血钙、免疫球蛋白、轻链蛋白定量水平，不良反应发生情况及3年生存情况。结果观察组近期总有效率为78．4％（29／37），高于对照组的56．8％（21／37）（χ2＝3．947， P ＝0．047）；观察组血清肌酐、尿酸、血钙、轻链蛋白定量水平显著低于对照组（ t ＝19．081、1．979、5．877、2．205， P ＝0．000、0．025、0．000、0．015），而血清免疫球蛋白无明显变化（ t ＝1．492， P ＝0．069）。2组患者化疗过程中均发生恶心／呕吐、腹胀、便秘、食欲不振、口干、睡眠不佳、骨髓抑制、心脏毒性等不良症状，2组患者不良反应发生率比较，差异均无统计学意义（ P ＞0．05）。2组患者化疗后随访10～36个月，中位随访时间21．7个月；观察组3年生存率为40．5％，对照组3年生存率为37．8％，2组比较差异无统计学意义（χ2＝0．153， P ＝0．696）。结论化疗联合血液净化治疗多发性骨髓瘤肾病伴肾功能不全患者可有效改善微循环，有利于提高化疗临床效果，安全有效，值得临床推广应用。
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