外周血血红蛋白、白蛋白、IgG及C1q水平对多发性骨髓瘤骨病患者化疗效果及预后的评估价值  

Evaluated value of peripheral blood hemoglobin, albumin, IgG and C1q on chemotherapy effect and prognosis in patients with multiple myeloma

作　　者：祁继金 仲青 张耀云 慎旋 沈洁[2] QI Ji-jin;ZHONG Qing;ZHANG Yao-yun(Department of Hematology,Suqian Hospital of Jiangsu Provincial People's Hospital(Suqian First People's Hospital Affiliated to Nanjing Medical University,Suqian Branch of Jiangsu Provincial People's Hospital),Suqian Jiangsu 223800,China)

机构地区：[1]江苏省人民医院宿迁医院(南京医科大学附属宿迁第一人民医院江苏省人民医院宿迁分院)血液内科,江苏宿迁223800 [2]江苏省人民医院宿迁医院(南京医科大学附属宿迁第一人民医院江苏省人民医院宿迁分院)医学检验科,江苏宿迁223800

出　　处：《临床和实验医学杂志》2025年第1期29-33,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省自然科学基金项目(编号:BK20211024)。

摘　　要：目的 探究血清血红蛋白、白蛋白、免疫球蛋白G(IgG)及补体C1q(C1q)水平对多发性骨髓瘤(MM)患者化疗效果及预后的影响。方法 回顾性分析2018年2月至2019年2月江苏省人民医院宿迁医院收治入院接受化疗的160例MM患者资料。采用Durie-Salmon(DS)分期法将患者分为Ⅰ期(n=44)、Ⅱ期(n=74)和Ⅲ期(n=42)。根据化疗疗效分为治疗缓解组(n=98)和无明显缓解组(n=62)。比较不同分期、不同化疗疗效的MM患者血清血红蛋白、白蛋白和IgG水平;Spearman分析MM患者血清血红蛋白、白蛋白、IgG及C1q水平与疾病分期、疗效的相关性;根据随访结果分为生存组(n=118)和死亡组(n=42),对比不同预后患者基线资料及血清血红蛋白、白蛋白、IgG及C1q水平,分析血清血红蛋白、白蛋白、IgG及C1q水平对MM患者预后不良的评估价值。结果 不同分期MM患者血清血红蛋白、白蛋白、IgG及C1q水平比较,差异均有统计学意义(P<0.05),其中,Ⅲ期的血红蛋白、白蛋白、C1q水平均低于Ⅰ期、Ⅱ期,IgG水平高于Ⅰ期、Ⅱ期,差异均有统计学意义(P<0.05)。治疗缓解组患者血清血红蛋白、白蛋白、C1q水平分别为(93.26±13.24) g/L、(32.85±6.76) g/L、(134.28±22.79) mg/L,均显著高于无明显缓解组[(80.96±11.73) g/L、(28.29±5.96) g/L、(112.37±21.52) mg/L],IgG水平为(37.24±5.11)g/L,均显著低于无明显缓解组[(43.13±6.75)g/L],差异均有统计学意义(P<0.05)。Spearman相关性分析显示,血清血红蛋白、白蛋白、C1q水平与疾病分期呈显著负相关(P<0.05),与化疗疗效呈显著正相关(P<0.05),血清IgG水平与临床分期呈显著正相关(P<0.05),与化疗疗效呈显著负相关(P<0.05);随访时间截至2024年2月,42例患者死亡,DS分期、血清血红蛋白、白蛋白、IgG及C1q水平比较差异有显著性(P<0.05);受试者操作特征(ROC)曲线分析显示,血清血红蛋白、白蛋白、IgG及C1q单独及联合诊断MM患者预后不良的敏感度为79.1Objective To explore the influence on serum hemoglobin,albumin,immunoglobulin G(IgG)and complement C1q(C1q)levels on chemotherapy effect and prognosis in patients with multiple myeloma(MM).Methods The data of 160 patients with MM who received chemotherapy in Suqian Hospital of Jiangsu Provincial People's Hospital from February 2018 to February 2019 were retrospectively analyzed.The patients were divided into stageⅠ(n=44),stageⅡ(n=74)and stageⅢ(n=42)by Durie-Salmon(DS)staging method.According to the efficacy of chemotherapy,the patients were divided into treatment remission group(n=98)and no significant remission group(n=62).Serum hemoglobin,albumin,IgG and C1q levels were compared among patients with MM of different stages and different chemotherapy effects.Spearman correlation analysis was used to analyze the correlation between serum hemoglobin,albumin,IgG and C1q levels and disease staging and curative effect in patients with MM.According to the follow-up results,the patients were classified into survival group(n=118)and death group(n=42).Baseline data and serum hemoglobin,albumin,IgG and C1q levels of patients with different prognosis were compared,and the evaluated value of serum hemoglobin,albumin,IgG and C1q levels on poor prognosis of MM patients was analyzed.Results There were statistically significant differences in serum hemoglobin,albumin,IgG and C1q levels among patients with different stages of MM(P<0.05);among them,the levels of hemoglobin,albumin and C1q in stageⅢwere lower than those in stageⅠand stageⅡ,and the levels of IgG in stageⅢwere higher than those in stageⅠand stageⅡwere statistically significant(P<0.05).The levels of serum hemoglobin,albumin and C1q in the treatment improvement group were(93.26±13.24)g/L,(32.85±6.76)g/L and(134.28±22.79)mg/L,respectively,which were significantly higher than those in the non-obvious remission group[(80.96±11.73)g/L,(28.29±5.96)g/L,(112.37±21.52)mg/L],and the IgG level was(37.24±5.11)g/L,which was significantly lower than that in

关 键 词：多发性骨髓瘤 化疗 预后 血红蛋白 白蛋白 免疫球蛋白G 

分 类 号：R733.3[医药卫生—肿瘤]