PC、C1q、β2M与多发性骨髓瘤患者预后的关系及预测价值  

Relationship and predictive value of PC,C1q,β2M and prognosis in patients with multiple myeloma

作　　者：李娜[1] 周伯炜 庞龙 王露 梁艳[2] LI Na;ZHOU Bo-wei;PANG Long(Department of Hematology,General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.,Taiyuan Shanxi 030008,China)

机构地区：[1]太原钢铁(集团)有限公司总医院血液内科,山西太原030008 [2]太原市妇幼保健院(太原市儿童医院)检验科,山西太原030012

出　　处：《临床和实验医学杂志》2025年第5期482-486,共5页Journal of Clinical and Experimental Medicine

基　　金：中国金属学会冶金安全与健康分会健康卫生科研项目(编号:jkws202410)。

摘　　要：目的探讨血浆蛋白C(PC)、补体C1q(C1q)、β2-微球蛋白(β2M)与多发性骨髓瘤患者预后的关系及预测价值。方法回顾性选取2017年6月至2023年12月在太原钢铁(集团)有限公司总医院接受治疗的多发性骨髓瘤患者94例作为观察组,选取同期来本院的健康体检者100名作为对照组。比较观察组和对照组的PC、C1q、β2M水平差异,同时分析观察组不同临床特征患者PC、C1q、β2M水平差异。比较不同预后患者临床资料;采用Cox回归模型分析影响多发性骨髓瘤患者预后的因素;采用受试者操作特征(ROC)曲线分析PC、C1q和β2M预测多发性骨髓瘤患者死亡的价值。结果观察组PC和C1q水平分别为(92.02±18.40)%和(122.23±32.23)mg/L,均明显低于对照组[(117.70±20.01)%和(203.34±44.45)mg/L],而β2M水平为(9.50±1.10)mg/L,明显高于对照组[(1.24±0.33)mg/L],差异均有统计学意义(P<0.05)。观察组国际分期系统(ISS)分期Ⅲ期患者PC和C1q水平分别为(89.23±15.33)%和(105.75±33.57)mg/L,均明显低于Ⅰ~Ⅱ期患者[(98.29±15.54)%、(135.54±31.17)mg/L],而β2M为(10.11±1.02)mg/L,明显高于Ⅰ~Ⅱ期患者[(9.01±0.99)mg/L],差异均有统计学意义(P<0.05)。死亡患者年龄>60岁比例、ISS分期Ⅲ期比例、β2M水平分别为68.00%、68.00%和(10.43±1.32)mg/L,均高于存活患者[36.36%、18.18%、(8.44±1.15)mg/L],PC和C1q水平分别为(87.83±18.10)%和(104.43±31.12)mg/L,均明显低于存活患者[(97.22±17.49)%和(142.46±35.54)mg/L],差异均有统计学意义(P<0.05)。Cox回归模型分析显示:ISS分期、PC、C1q和β2M是患者预后的影响因素(P<0.05)。PC、C1q和β2M预测多发性骨髓瘤患者死亡的ROC曲线下面积分别为0.905、0.843和0.851(P<0.05)。结论多发性骨髓瘤患者PC和C1q水平降低,而β2M水平升高,是患者预后的影响因素,同时在预测患者预后方面有一定应用价值。Objective To explore the relationship and predictive value of plasma protein C(PC),complement C1q(C1q),andβ2-microglobulin(β2M)with prognosis in patients with multiple myeloma.Methods A total of 94 patients with multiple myeloma treated in General Hospital of Taiyuan Iron and Steel(Group)Co.,LTD.from June 2017 to December 2023 were retrospectively selected as the observation group,and 100 healthy subjects who come to our hospital during the same period were selected as the control group.The differences in PC,C1q,andβ2M levels between the two groups were compared,and the differences in PC,C1q,andβ2M levels among patients with different clinical characteristics in the observation group were analyzed.The factors affecting the prognosis of patients with multiple myeloma was analyzed using Cox regression model.The value of PC,C1q andβ2M in predicting the death of patients with multiple myeloma was analyzed using the receiver operating characteristic(ROC)curve.Results The levels of PC and C1q in the observation group were(92.02±18.40)%and(122.23±32.23)mg/L,respectively,which were significantly lower than those in the control group[(117.70±20.01)%and(203.34±44.45)mg/L],while the level ofβ2M in the observation group was(9.50±1.10)mg/L,which was significantly higher than that in the control group[(1.24±0.33)mg/L],the differences were statistically significant(P<0.05).The PC and C1 q of international staging system(ISS)stageⅢpatients in the observation group were(89.23±15.33)%and(105.75±33.57)mg/L,which were significantly lower than those of stageⅠ-Ⅱpatients[(98.29±15.54)%,(135.54±31.17)mg/L],whileβ2M was(10.11±1.02)mg/L,which was significantly higher than that of stageⅠ-Ⅱpatients[(9.01±0.99)mg/L],the differences were statistically significant(P<0.05).The proportion of deceased patients in the observation group aged>60 and the proportion of ISS stageⅢpatients,the level ofβ2M were 68.00%and 68.00%,(10.43±1.32)mg/L,respectively,which were higher than those of surviving patients[36.36%,18.18%,

关 键 词：多发性骨髓瘤 预后 血浆蛋白C 补体C1Q Β2-微球蛋白 

分 类 号：R733.3[医药卫生—肿瘤]