摘要
目的探讨血脂相关指标在多发性骨髓瘤(MM)预后判断中的意义。方法回顾性分析80例MM患者的血脂水平,其中R-ISS分期Ⅰ期7例,Ⅱ期49例,Ⅲ期24例;以80例健康体检者为对照组。所有受试者均检测空腹血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。探讨血脂参数与R-ISS分期系统、细胞遗传学、总生存时间(OS)之间的相关性。结果80例MM患者中,R-ISS分期Ι期患者TC、TG、HDL-C、LDL-C与对照组比较差异无统计学意义(P>0.05);Ⅱ期患者TG高于对照组,HDL-C、LDL-C低于对照组(P<0.05);Ⅲ期患者TC、HDL-C、LDL-C均低于对照组(P<0.05)。荧光原位杂交(FISH)阴性组TC、HDL-C和LDL-C低于对照组(P<0.05);FISH非高危组TG高于对照组,HDL-C低于对照组(P<0.05);FISH高危组TC、HDL-C低于对照组(P<0.05)。总生存时间单因素分析结果表明,死亡组和生存组4项血脂指标差异无统计学意义(P>0.05);总生存时间Cox多因素分析结果显示,TC<3.6 mmol·L^(-1)(HR=0.034,95%CI0.004~0.325,P=0.003)、LDL-C<2.1 mmol·L^(-1)(HR=25.887,95%CI2.731~245.216,P=0.005)是影响患者总生存时间的独立预后因素。结论血脂相关指标与MM临床分期、FISH、总生存时间密切相关,低水平TC、LDL-C是影响MM患者生存的独立预后因素。
Objective To investigate the significance of blood lipid-related indicators in multiple myeloma(MM)prognosis.Methods The blood lipid levels of 80 patients with MM were retrospectively analyzed,including 7 cases of R-ISS stage I,49 cases in phase II,and 24 cases in phase III.A control group consists of 80 health checkups.All subjects were detected by fasting serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C).The correlation between blood lipid parameters and R-ISS stage system,cell genetics(FISH),total survival time(OS)were explored.Results In 80 patients with MM,TC,Tg,HDL-C,and LDL-C were compared with those in the control group(P>0.05);Tg was higher,HDL-C,LDL-C were lower(P<0.05);in phase III patients,TC,HDL-C,LDL-C were lower(P<0.05).In the FISH negative group,TC,HDL-C and LDL-C were lower than those in the control group(P<0.05);in the FISH non-high risk,TG was higher,and HDL-C was lower(P<0.05);in the FISH high-risk group,TC and HDL-C were lower(P<0.05).The total survival time single factor analysis showed that there was no significant difference between 4 blood lipids in the death group and the survival group(P>0.05);total survival time Cox multi-factor analysis results showed that TC<3.6 mmol·L^(-1)(HR=0.034,95%CI:0.004~0.325,P=0.003)and LDL-C<2.1 mmol·L^(-1)(HR=25.887,95%CI:2.731~245.216,P=0.005)were independent prognostic factors affecting patients’the total survival time.Conclusion Blood lipid-related indicators are closely related to MM clinical stages,FISH and total survival time.Low-level TC and LDL-C are independent prognostic factor affecting the survival of MM patients.
作者
何兴娟
杨学农
武文双
张建东
张松
武湘云
HE Xing-juan;YANG Xue-nong;WU Wen-shuang;ZHANG Jian-dong;ZHANG Song;WU Xiang-yun(Department of Clinical Laboratory,The Third Hospital of Hebei Medical University,Shijiazhuang,Hebei 050050,China)
出处
《河北北方学院学报（自然科学版）》
2021年第6期14-18,共5页
Journal of Hebei North University:Natural Science Edition
基金
河北省医学科学研究重点课题计划(No.20160587)。
关键词
多发性骨髓瘤
血脂
预后
临床分期
multiple myeloma
serum lipid
prognosis
clinical stage
