实验室指标在多发性骨髓瘤辨证分型中的应用  

Application of Laboratory Indexes in Traditional Chinese Medicine Syndrome Differentiation of Multiple Myeloma

作　　者：肖明锋[1] 刘基铎[1] 袁晴[1] 刘光平[1] 

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2018年第1期55-62,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研课题(编号:20162075)

摘　　要：【目的】研究多发性骨髓瘤(multiple myeloma,MM)的中医辨证分型与实验室指标的关系,探讨不同证型间这些指标的变化及辅助MM中医辨证分型的可能性。【方法】收集MM患者59例进行中医辨证分型,检测血清蛋白电泳(SPE)、免疫固定电泳(IFE)、尿素氮(BUN)、肌酐(CREA)、血β2微球蛋白、血钙(Ca)、血红蛋白(Hb)、尿本周氏蛋白指标,骨髓穿刺进行流式细胞免疫表型(FCM)检测及骨髓细胞学检查,分析这些指标在MM中医辨证分型间的差异。【结果】不同中医分型间骨髓瘤细胞形态、M蛋白含量、IFE分型结果、尿本周氏蛋白阳性率、Ca浓度等均无显著性差异(P>0.05),而BUN、CREA、血β2微球蛋白、Hb水平及CD19-、CD56+的阳性率等有显著性差异(P<0.05或P<0.01),且Hb、BUN、CREA、血β2微球蛋白之间存在显著性相关(P<0.05或P<0.01)。【结论】联合Hb、BUN、CREA、血β2微球蛋白以及FCM检测可以辅助MM的中医辨证分型诊断,并可以初步判断疾病的严重程度和预后,为之后的中西医治疗提供依据。Objective To study the relationship between traditional Chinese medicine（TCM）syndrome differentiation of multiple myeloma（MM）and laboratory indexes of MM,thus to supply evidence for the syndrome differentiation of MM. Methods A total of 59 MM patients were enrolled in the study. TCM syndrome differentiation was performed. And we also collected the laboratory indexes of serum protein electrophoresis（SPE）,immunofixation electrophoresis（IFE）,blood urea nitrogen（BUN）,creatinine（CREA）,serum beta 2 microglobulin,serum calcium（Ca）,hemoglobin（Hb）,Bence Jones protein,flow cytometric-immunophenotyping（FCM） and bonemarrow cytology. The differences of the laboratory indexes in various syndrome types of MM were analyzed.Results No significant differences were found in myeloma cell morphology, M protein content, IFE typing results, Bence Jones protein positive rate and the concentration of Ca of various syndrome types of MM（P 0.05）. However,the concentrations of BUN,CREA,serum beta 2 microsglobulin,Hb,and the positive rates of CD19-and CD56＋were significantly different in various syndrome types of MM（P 0.05 or P 0.01）.Moreover,Hb,BUN,CREA,and serum beta 2 microspheres were significantly correlated with each other（P 0.05 or P 0.01）. Conclusion Hb, BUN, CREA, blood beta 2 microglobulin and FCM detection can be sued for the auxiliary diagnosis of syndrome types of MM,and for preliminary demonstration of illness severity and prognosis. The results will provide the basis for the treatment of MM with traditional Chinese medicine and western medicine.

关 键 词：多发性骨髓瘤 中医证型 实验室指标 

分 类 号：R733.3[医药卫生—肿瘤]