目的探讨沙利度胺联合苯丙氨酸氮芥及泼尼松对难治性复发性骨髓瘤的治疗效果。方法选取2012年10月至2015年10月于沈阳市红十字会医院诊治的难治性复发性骨髓瘤患者83例为研究对象,按随机抽签原则分为对照组和研究组。对照组41例患者应用苯丙氨酸氮芥联合泼尼松方案治疗,研究组42例患者在苯丙氨酸氮芥联合泼尼松治疗的基础上加用沙利度胺,比较两组患者的治疗有效率、不良反应发生率及复发率。结果 1研究组患者的治疗有效率为73.8%,骨髓瘤复发率为7.1%;对照组患者的治疗有效率为43.9%,骨髓瘤复发率为24.4%;两组患者的治疗有效率与骨髓瘤复发率比较,差异均有统计学意义(均P<0.01或P<0.05)。2研究组患者与对照组患者双下肢水肿、肢端麻木、红色斑丘疹、便秘和嗜睡的发生率比较,差异均无统计学意义(均P>0.05)。结论沙利度胺联合苯丙氨酸氮芥、泼尼松对难治性复发性骨髓瘤的治疗效果确切,可明显改善患者的临床症状,降低其复发率,但不会增加患者的不良反应,安全性较高,可作为难治性复发性骨髓瘤的首选用药方案。 Objective To investigate the therapeutic effect of thalidomide combined with melphalan and prednisone on refractory recurrent myeloma. Methods Eighty-three patients with refractory recurrent myeloma who were diagnosed and treated in Shenyang Red Cross Hospital from October 2012 to October 2015 were selected as the research object. According to the principle of random lottery, they were divided into control group and study group. Forty-one patients in the control group were treated with melphalan and prednisone. Forty-two patients in the study group were given thalidomide combined with melphalan and prednisone, and patients in both groups were compared Therapeutic efficiency, adverse reactions and recurrence rate. Results 1 The study group of patients with effective rate was 73.8%, the recurrence rate of myeloma was 7.1%; the control group, the effective rate was 43.9%, the recurrence rate of myeloma was 24.4%; two groups of patients with the effective rate of myeloma Relapse rate, the difference was statistically significant (P <0.01 or P <0.05). There was no significant difference in the incidence of edema, acral numbness, red rash, constipation and drowsiness between study group and control group (all P> 0.05). Conclusions Thalidomide combined with melphalan and prednisone has definite therapeutic effect on refractory recurrent myeloma, which can significantly improve the clinical symptoms and reduce the recurrence rate of patients, but does not increase the adverse reactions in patients , High safety, can be used as the first choice of refractory recurrent myeloma regimen.