不同血液分离结果的多发性骨髓瘤患者临床特征及预后分析  

Clinical Characteristics and Prognosis of Multiple Myeloma Patients with Different Results of Blood Separation

作　　者：张靖宇[1] 范洪[1] 张静[1] 赵倩[1] 许迪[2] 尤芳芳[2] 郭丽[2] 张华[2] ZHANG Jing-Yu;FAN Hong;ZHANG Jing;ZHAO Qian;XU Di;YOU Fang-Fang;GUO Li;ZHANG Hua(Department of Laboratory Diagnosis,Cangzhou Integrated of Traditional Chinese and Western Medicine Hospital of Hebei Province,Cangzhou 061001,Hebei Province,China;Department of Hematology,Cangzhou Integrated of Traditional Chinese and Western Medicine)

机构地区：[1]河北省沧州中西医结合医院实验诊断科,河北沧州061001 [2]河北省沧州中西医结合医院血液科,河北沧州061001

出　　处：《中国实验血液学杂志》2020年第2期547-552,共6页Journal of Experimental Hematology

基　　金：河北省人才工程培养资助项目(A201901110);河北省卫健委重点科技研究计划(20191283);沧州市科学技术研究与发展指导计划项目(172302167)。

摘　　要：目的:研究分离胶真空采血管离心后2种不同血液分离结果的多发性骨髓瘤(MM)患者的临床特征,并比较2种分离结果对MM患者预后的价值。方法:回顾性分析本院2009年3月至2017年12月收治的168例初诊MM患者的临床资料,并根据分离胶真空采血管离心后血液分离结果将血液样本分为对照组(自上而下依次为血清、胶体、红细胞)和异常组(自上而下依次为血清、红细胞、胶体、红细胞),比较2组患者的年龄、性别、生化指标(总蛋白、白蛋白、免疫球蛋白、β2微球蛋白、血钙、乳酸脱氢酶、肌酐)、血常规指标(血红蛋白、血小板)以及免疫分型和临床分期等临床数据的差异;分析血液分离结果与疗效的关系,并比较2组患者总生存期(OS)的差异。结果:对照组和异常组的总蛋白、白蛋白、免疫球蛋白、β2微球蛋白、血红蛋白、免疫分型、临床分期差异明显(P<0.05),而性别、年龄、血钙、乳酸脱氢酶、肌酐、血小板在2组间无明显差异(P>0.05)。异常组治疗后获得完全缓解(CR)和非常好的部分缓解(VGPR)的患者血液分离结果转为正常,部分缓解(PR)的患者血液分离结果部分转为正常、部分未发生变化,而获得PR疗效以下的患者血液分离结果没有变化,对照组患者治疗后获得PR疗效以下的患者血液分离结果部分转为异常;正常血液分离结果患者具有较好的OS,而异常血液分离结果患者的OS明显缩短。结论:MM患者血液离心后存在异常分离现象;异常分离现象与总蛋白、白蛋白、免疫球蛋白、β2微球蛋白、血红蛋白、免疫分型及临床分期有关。这提示,异常分离存在更高的肿瘤负荷;正常血液分离结果提示预后较好,而异常血液分离结果提示预后不良。Objective:To investigate clinical characteristics of multiple myeloma(MM)patients with two different results of blood separation in vacum blood collection tubes containing separator gels after centrifugation,and evaluate the prognostic value of these two results.Methods:The clinical data of 168 patients with newly diagnosed MM treated in our hospital from March 2009 to December 2017 were retrospectively analyzed.The blood samples were divided into control group(the order from top to bottom is serum,separator gel and red blood cell)and abnormal group(the order from top to bottom is serum,red blood cell,separator gel and red blood cell)according to the results of blood separation in vacum blood collection tubes containing separator gels after centrifugation.The differences of age,sex,biochemical indexes(total protein,albumin,immunoglobulin,β2 microglobulin,calcium,lactate dehydrogenase,creatinine),blood routine indexes(hemoglobin,Plt),immunophenotyping and clinical staging of patients were compared;and the relationship between the results of blood separation and efficacy was analyzed and the difference of overall survival(OS)time between the two groups was compared.Results:There was significant difference in total protein,albumin,immunoglobulin,β2 microglobulin,hemoglobin,immunophenotyping,clinical stage between control group and abnormal group(P<0.05).However the differences of sex,age,calcium,lactate dehydrogenase,creatinine,Plt showed no statistically significant(P>0.05).Patients in abnormal group obtained complete remission(CR)or very good partial remission(VGPR)showed normal results in blood separation after treatment.Patients obtained partial remission(PR)showed partly normalized and partly unchanged,while patients obtained less than PR showed unchanged.Patients in control group obtained less than PR partly showed abnormal results in blood separation after treatment;Patients with normal results in blood separation showed long OS time,while patients with abnormal results of blood separation showed obviously

关 键 词：多发性骨髓瘤 分离胶 真空采血管 临床特征 预后 

分 类 号：R733.3[医药卫生—肿瘤]