胱抑素C、铁蛋白与骨髓瘤骨病病情严重程度及预后的关系  

Relationship Between Cystatin C,Ferritin and the Severity,Prognosis of Multiple Myeloma Bone Disease

作　　者：张慧敏[1] 夏海龙[1] 刘北 焦燕 ZHANG Hui-min;XIA Hai-long;LIU Bei;JIAO Yan(Department of Hematology,Chaohu Hospital of Anhui Medical University,Heifei 230026,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院血液内科,安徽合肥230026

出　　处：《医学信息》2024年第3期89-93,113,共6页Journal of Medical Information

摘　　要：目的探索血清胱抑素C、铁蛋白与骨髓瘤骨病(MBD)严重程度及预后的相关性。方法回顾性分析安徽医科大学巢湖医院和安徽医科大学第一附属医院2017年10月-2021年10月的152例MBD患者的临床数据。依据影像学检查结果按病情的轻重将MBD患者分为A、B、C、D组,应用免疫比浊法测定四组血清胱抑素C和铁蛋白的水平,比较4组血清指标的变化,并用Spearman法分析血清胱抑素C和铁蛋白与MBD严重性之间的相关性。将全部患者按生存情况划分为生存组和死亡组,应用Cox回归对其预后相关因素进行分析。结果血清胱抑素C和铁蛋白水平随患者病情严重程度的加重呈上升趋势(P<0.05);Spearman分析发现血清胱抑素C和铁蛋白的水平与MBD病情严重程度呈正相关(r=0.735、0.801,P<0.05);截至随访时间,152例患者中存活98例(64.47%),死亡54例(35.53%),死亡组病理性骨折骨病类型比例、血清胱抑素C和铁蛋白水平均高于存活组(P<0.05);血清胱抑素C、铁蛋白高低水平生存曲线比较,差异有统计学意义(P<0.05);Cox回归分析显示血清胱抑素C、铁蛋白、病理性骨折等是MBD患者预后的危险因素(P<0.05)。结论血清胱抑素C、铁蛋白水平随着MBD病情加重而增高,两者均为MBD患者的预后危险因素。Objective To explore the correlation between serum cystatin C,ferritin and the severity,prognosis of myeloma bone disease(MBD).Methods The clinical data of 152 MBD patients in Chaohu Hospital of Anhui Medical University and the First Affiliated Hospital of Anhui Medical University from October 2017 to October 2021 were retrospectively analyzed.According to the results of imaging examination,MBD patients were divided into groups A,B,C and D according to the severity of the disease.The levels of serum cystatin C and ferritin in the four groups were determined by immunoturbidimetry.The changes of serum indexes in the four groups were compared.Spearman method was used to analyze the correlation between serum cystatin C,ferritin and the severity of MBD.All patients were divided into survival group and death group according to their survival status,and Cox regression was used to analyze the prognostic factors.Results The levels of serum cystatin C and ferritin increased with the severity of the disease(P<0.05).Spearman analysis showed that the levels of serum cystatin C and ferritin were positively correlated with the severity of MBD(r=0.735,0.801,P<0.05).As of the follow-up time,98 of the 152 patients survived(64.47%)and 54 patients died(35.53%).The proportion of pathological fracture bone disease types,serum cystatin C and ferritin levels in the death group were higher than those in the survival group(P<0.05).There were significant differences in the survival curves of serum cystatin C and ferritin between high and low levels(P<0.05).Cox regression analysis showed that serum cystatin C,ferritin and pathological fracture were risk factors for the prognosis of MBD patients(P<0.05).Conclusion The levels of serum cystatin C and ferritin increase with the severity of MBD,both of which are prognostic risk factors for MBD patients.

关 键 词：多发性骨髓瘤骨病 胱抑素C 铁蛋白 

分 类 号：R733.3[医药卫生—肿瘤]