多发性骨髓瘤118例临床特征调查及治疗无效的影响因素分析  

Clinical characteristics of 118 cases of multiple myeloma and analysis of influencing factors of ineffective treatment

作　　者：冯丽倩 李栋梁 王友君 李素欣 安乐 FENG Liqian;LI Dongliang;WANG Youjun;LI Suxin;AN Le(Department of Hematology,Shijiazhuang People's Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市人民医院血液内科,河北石家庄050000

出　　处：《安徽医药》2023年第12期2438-2442,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省2021年度医学科学研究课题计划项目(20210067)。

摘　　要：目的调查多发性骨髓瘤(MM)病人的临床特征并分析其治疗无效的影响因素。方法选取石家庄市人民医院2012年1月至2020年3月收治的118例的MM病人,统计病人性别、年龄、血常规、血肌酐、血钙离子、乳酸脱氢酶(LDH)、血清白蛋白、病理类型等临床特征。根据治疗效果将其分为有效组和无效组,采用logistic多元回归分析探讨病人治疗无效的影响因素。结果MM病人中男性占比高于女性,平均年龄49.52岁,身体质量指数>25 kg/m^(2)、血肌酐、血钙离子、LDH水平升高、贫血、骨骼损害、合并淀粉样变、白蛋白水平降低、修订的国际分期体系(R-ISS)分期Ⅰ期、免疫球蛋白G型(IgG型)、轻链型、免疫球蛋白A型(IgA型)、国际骨髓瘤工作组(IMWG)10%~50%、<10%占比高;MM病人治疗无效率为40.68%(48/118),且治疗无效病人年龄[(58.75±10.18)岁,(43.19±5.63)岁]、血肌酐水平升高[38(79.17%),33(47.14%)]、血钙离子水平升高[35(72.92%),30(42.86%)]、血清LDH水平升高[36(75.00%),31(44.29%)]、贫血[35(72.92%),27(38.57%)]、骨骼损害[19(39.58%),12(17.14%)]、合并淀粉样变[14(29.17%),7(10.00%)]、白蛋白水平降低[38(79.17%),32(45.71%)]、骨髓浆细胞百分比(BMPC%)<10%[22(45.83%),18(25.71%)]、未依从治疗[7(14.58%),1(1.43%)]占比均高于治疗有效病人(P<0.05),诱导+造血干细胞移植治疗[7(14.58%),22(31.43%)]占比低于治疗有效病人(P<0.05)。结论MM常见于男性、成人、超重人群,其疗效影响因素较多。Objective To investigate the clinical characteristics of patients with multiple myeloma(MM)and to analyze the factors influencing ineffective treatment.Methods A total of 118 MM patients admitted to Shijiazhuang People's Hospital from January 2012 to March 2020 were selected,and clinical characteristics such as sex,age,routine blood test,serum creatinine,serum calcium ion,lactate dehydrogenase(LDH),serum albumin and pathological types were determined.According to the treatment effect,the patients were divided into effective and ineffective groups.Logistic multiple regression analysis was used to explore the influencing factors of the patients'ineffective treatment.Results The proportion of males in MM patients was higher than that of females,with an average age of 49.52 years,with body mass index>25 kg/m2,elevated serum creatinine,serum calcium ions,LDH levels,anemia,bone damage,combined amyloidosis,decreased albumin levels,Revised International Staging System(R-ISS)stage I,immunoglobulin G(IgG),light chain,immunoglobulin A(IgA),International Myeloma Working Group 10%~50%,<10% was high;the treatment inefficiency of MM patients was 40.68%(48/118),and the age of patients with ineffective treatments[(58.75±10.18)years,(43.19±5.63)years],elevated serum creatinine level[38(79.17%),33(47.14%)],and elevated blood calcium ion level[35(72.92%),30(42.86%)],elevated serum LDH level[36(75.00%),31(44.29%)],anemia[35(72.92%),27(38.57%)],bone damage[19(39.58%),12(17.14%)],combined amyloidosis[14(29.17%),7(10.00%)],decreased albumin level[38(79.17%),32(45.71%)],bone marrow plasma cell percentage(BMPC%)<10%[22(45.83%),18(25.71%)],and noncompliance with treatment[7(14.58%),1(1.43%)]were higher those that of patients with effective treatment(P<0.05),and the proportion of induced+hematopoietic stem cell transplantation treatment[7(14.58%),22(31.43%)]was lower than that of patients with effective treatment(P<0.05).Conclusion MM is common in males,adults,and overweight people,and its efficacy is influenced by many factors.

关 键 词：多发性骨髓瘤 肌酸酐 L-乳酸脱氢酶 免疫球蛋白类 临床特征 危险因素 

分 类 号：R733.3[医药卫生—肿瘤]