同型半胱氨酸代谢酶基因多态性与汉族多发性骨髓瘤预后的关系  

Relationship between homocysteine metabolizing enzyme gene polymorphism and prognosis of multiple myeloma in Han nationality

作　　者：张灵[1] 陈哲[1] 范凌[1] 张斌[2] 高炳华[1] Zhang Ling;Chen Zhe;Fan Ling;Zhang Bin;Gao Binghua(Department of Hematology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Laboratory Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院血液科,张家口075000 [2]河北北方学院附属第一医院检验科,张家口075000

出　　处：《中国医师进修杂志》2022年第12期1066-1070,共5页Chinese Journal of Postgraduates of Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200548)。

摘　　要：目的探讨同型半胱氨酸(Hcy)代谢酶基因多态性与汉族多发性骨髓瘤(MM)预后不良的关系。方法选取河北北方学院附属第一医院2018年2月至2020年3月收治的128例汉族MM患者(疾病组)和同期招募的120例汉族健康志愿者(对照组)为研究对象,两组均检测血浆Hcy水平及Hcy代谢酶基因多态性,包括亚甲基四氢叶酸还原酶(MTHFR)C677T、MTHFR A1298C、蛋氨酸合成酶还原酶(MTRR)A66G、胱硫醚β合成酶(CBS)844ins68、蛋氨酸合成酶(MS)A2756G。疾病组采用常规方法治疗,于治疗后跟踪随访1年并统计预后不良的发生情况,采用Logistic多元回归分析Hcy代谢酶基因多态性与疾病组预后不良的关系。结果疾病组血浆Hcy水平高于对照组[(15.01±2.98)μmol/L比(8.45±1.69)μmol/L],差异有统计学意义(P<0.05)。疾病MTHFR C677T位点TT基因型频率和T等位基因频率分别为26.56%、29.30%,高于对照组的6.67%、16.25%,CT基因型频率为5.47%,低于对照组的19.17%,差异均有统计学意义(P<0.05)。两组其余基因位点基因型分布和等位基因频率比较差异均无统计学意义(P>0.05)。疾病组预后不良的发生率为49.22%(63/128),年龄、血小板计数和血清β2微球蛋白、κ轻链、血浆Hcy水平及MTHFR C677T位点TT基因型均是疾病组预后不良的影响因素(OR=7.286、0.545、6.841、6.284、8.117、8.440,P<0.05)。结论汉族MM患者血浆Hcy水平、MTHFR C677T位点TT基因型频率和T等位基因频率均高于健康人群,CT基因型频率低于健康人群,且汉族MM患者预后不良与血浆Hcy水平、MTHFR C677T位点TT基因型有关。Objective To investigate the clinical relationship between homocysteine(Hcy)metabolizing enzyme gene polymorphism and poor prognosis of multiple myeloma(MM)in Han nationality.Methods One hundred and twenty-eight MM patients of Han nationality admitted to the First Affiliated Hospital of Hebei North University from February 2018 to March 2020 were selected as the disease group,and 120 healthy volunteers of Han nationality were recruited as the control group at the same time.Blood samples were taken to detect plasma Hcy level and Hcy metabolizing enzyme gene polymorphism,including methylenetetrahydrofolate reductase(MTHFR)C677T,MTHFRA1298C,methionine synthase reductase(MTRR)A66G,cystathionine beta-synthase(CBS)844ins68 and methionine synthase(MS)A2756G.The patients in the disease group were treated with conventional methods,followed up for 1 year after treatment,and the incidence of poor prognosis was counted.Plasma Hcy level,genotype distribution and allele frequency of Hcy metabolic enzymes were compared between the two groups.Logistic multiple regression analysis was used to analyze the association of Hcy metabolizing enzyme gene polymorphism with MM poor prognosis in Han nationality.Results The plasma Hcy level in the disease group was higher than that in the control group:(15.01±2.98)μmol/L vs.(8.45±1.69)μmol/L,there was statistical difference(P<0.05).The frequency of TT genotype and T allele of MTHFRC677T locus in the disease group were higher than those in the control group:26.56%vs.6.67%,29.30 vs.16.25%;while the frequency of CT genotype in the disease group was lower than that in the control group:5.47%vs.19.17%,there were statistical differences(P<0.05).There were no significant differences in genotype distribution and allele frequency of other gene loci between the two groups(P>0.05).The incidence of poor prognosis in the disease group was 49.22%(63/128).Age,platelet count,serumβ2 microglobulin level,serumκlight chain level,plasma Hcy level and TT genotype of MTHFRC677T locus were the influencing f

关 键 词：多发性骨髓瘤 预后 同型半胱氨酸代谢酶 基因多态性 

分 类 号：R733.3[医药卫生—肿瘤]