血清前白蛋白水平对初诊多发性骨髓瘤患者预后的影响  

Effect of serum prealbumin level on prognosis of newly diagnosed patients with multiple myeloma

作　　者：陆琴 张娣娣[2] LU Qin;ZHANG Didi(Department of Hematology,Nantong Haimen People's Hospital,Nantong,226100,China;Department of Oncology,Nantong Tumor Hospital)

机构地区：[1]江苏省南通市海门区人民医院血液科,江苏南通226100 [2]南通市肿瘤医院肿瘤科

出　　处：《临床血液学杂志》2023年第10期741-745,共5页Journal of Clinical Hematology

摘　　要：目的:探讨血清前白蛋白(prealbumin,PA)水平对初诊多发性骨髓瘤(multiple myeloma,MM)患者预后的影响。方法:纳入医院2014年1月—2020年12月收治的初诊MM患者进行前瞻性队列研究,根据患者初诊时血清PA的中位数,分为低水平组和高水平组,绘制2组生存曲线,比较2年生存状况;同时应用Cox比例风险模型进一步分析血清PA对初诊MM患者预后的影响。结果:共入选83例患者,其中2例失访,1例中途放弃治疗,最终80例患者进入研究。80例MM患者血清PA中位数为13.64 mg/dL,低水平组单核细胞计数、淋巴细胞计数、血小板计数、白蛋白水平低于高水平组,C反应蛋白水平高于高水平组(P<0.05)。高、低血清PA水平患者生存时间分别为(22.89±0.45)个月、(19.17±1.13)个月,低血清PA水平患者2年生存时间明显低于高水平组(χ^(2)=6.400,P=0.001)。无论是否调整混杂因素,血清PA低表达均可增加MM患者病死的风险(P<0.05);且每增加2 mg/dL血清PA,MM患者2年病死的风险明显降低(P<0.05)。结论:血清PA是影响初诊MM患者预后的独立危险因素。Objective To explore the effect of serum prealbumin(PA) level on the prognosis of newly diagnosed patients with multiple myeloma(MM).Methods A prospective cohort study was carried out among the newly diagnosed MM patients admitted to the hospital from January 2014 to December 2020. According to the median of serum PA at the time of initial diagnosis, the patients were divided into low level group and high level group. The survival curves of the two groups were drawn and the two-year survival status was compared. At the same time, Cox proportional risk model was used to further analyze the influence of serum PA on the prognosis of newly diagnosed MM patients.Results A total of 83 patients were enrolled, of which 2 case were lost, 1 case gave up treatment halfway, and finally 80 patients entered the study. The median of serum PA in 80 patients with MM was 13.64 mg/dL. The levels of monocyte count, lymphocyte count, platelet count and albumin in the low level group were lower than those in the high level group, and the level of C-reactive protein was higher than that in the high level group(P < 0.05). The survival time of patients with high and low serum PA levels was (22.89±0.45) months and (19.17±1.13) months, respectively. The 2-year survival time of patients with low serum PA level was significantly lower than that of patients with high serum PA level(χ^(2)=6.400, P=0.001). Whether or not the confounding factors were adjusted, the low expression of serum PA could increase the risk of death in MM patients(P < 0.05). The risk of death of patients with MM decreased significantly by 2 mg/dL of serum PA increased for 2 years (P < 0.05).Conclusion Serum PA may be an independent risk factor affecting the prognosis of newly diagnosed MM patients.

关 键 词：多发性骨髓瘤 前白蛋白 预后 

分 类 号：R733.3[医药卫生—肿瘤]