组织因子微粒在多发性骨髓瘤中的表达及临床意义  

Detection and clinical significance of microparticle-associated tissue factor in multiple myeloma

作　　者：候彦飞 杨林花[1] 任方刚[1] 张耀方[1] 秦秀玉[1] 白斯君[1] 杨晨[1] 王云鹏[1] 

机构地区：[1]山西医科大学第二医院血液科,太原030001

出　　处：《临床血液学杂志》2014年第4期573-576,共4页Journal of Clinical Hematology

基　　金：卫生公益性行业科研专项(No:201202017)

摘　　要：目的:检测多发性骨髓瘤(MM)患者血浆中组织因子微粒(MP-TF)的表达,探讨其临床意义。方法:将76例MM患者分为静脉血栓(VTE)组7例和非VTE组69例,应用流式细胞术检测76例MM患者治疗前后和30例健康献血员(对照组)血浆中MP-TF水平。结果:①VTE组治疗前后MP-TF水平差异有统计学意义[(62.70±1.63)%∶(82.07±3.39)%,P<0.01],VTE组治疗前后MP-TF水平均明显高于对照组的(37.50±16.29)%,均P<0.01。②非VTE组治疗前MP-TF水平明显高于治疗后和对照组[(60.92±14.29)%∶(46.33±15.88)%∶(37.50±16.29)%,均P<0.01]。③VTE组治疗后MP-TF水平明显高于非VTE组治疗后[(82.07±3.39)%∶(46.33±15.88)%,P<0.01]。④MM患者组内血小板升高的患者MP-TF水平明显高于血小板正常及减少患者[(66.38±8.46)%∶(51.72±11.15)%,P<0.01];D二聚体升高的患者MP-TF水平高于D二聚体正常及减少的患者[(61.46±10.70)%∶(53.68±16.83)%,P<0.05];凝血酶原时间(PT)延长>3s的患者MP-TF水平低于PT延长<3s患者[(48.84±15.25)%∶(53.40±17.12)%,P<0.05];浆细胞比例>15%的患者MP-TF水平明显高于浆细胞比例<15%的患者[(61.41±15.52)%∶(48.90±14.84)%,P<0.01]。⑤MP-TF水平与PT水平呈负相关(r=-0.302,P<0.05);MP-TF水平与浆细胞比例呈显著正相关(r=0.509,P<0.01)。结论:初诊MM患者血浆MP-TF水平高表达,治疗后明显下降,但并发VTE的患者治疗后MP-TF水平有所增高。MP-TF与MM患者血栓形成有一定关系,可作为一项监测病情进展的指标。Objective：To detect the expression of microparticle-associated tissue factor（MP-TF）in multiple myeloma（MM）patients and to discuss its clinical significance.Method：The plasma MP-TF level was detected in76cases of MM patients and 30healthy blood donors by flow cytometry.The MM patients were divided into venous thrombus embolism（VTE）group（n=7）and non-VTE group（n=69）.Result：①The level of MP-TF in VTE group before and after treatment had statistical significance（P〈0.01）,and both of them were higher than that in control group（P〈0.01）.②The level of MP-TF in non-VTE group before treatment was significantly higher than that after treatment and control group（P〈0.01）.③MP-TF level after treatment in VTE group was significantly higher than that in non-VTE group（P〈0.01）.④MP-TF level in the patients with platelet300×10^9/L was higher than that with platelet300×109/L（P〈0.01）.In the patients with D dimer250ng/ml it was higher than that with D dimer250ng/ml（P〈0.05）.In the patients with PT extension3sit was lower than that with PT extension3s（P〈0.05）.In the patients with plasma cell proportion15%it was significantly higher than that with plasma cell proportion15%（P〈0.01）.⑤MP-TF level was negatively correlated with PT（r=-0.302,P〈0.05）and was positively correlated with ratio of plasma cell（r=0.509,P〈0.01）.Conclusion：MP-TF expression is high in patients with newly diagnosed MM,which is significantly decreased after treatment,but MP-TF level is increased in the patients with VTE.Level of MP-TF is related to thrombosis in MM patients,which can be used as a index to monitor disease progression.

关 键 词：组织因子微粒 多发性骨髓瘤 静脉血栓形成 流式细胞术 

分 类 号：R733.3[医药卫生—肿瘤]