164例多发性骨髓瘤患者的临床特征分析

发布时间：2018-05-20 08:51

本文选题：多发性骨髓瘤 + 临床特征　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨多发性骨髓瘤(Multiple myeloma,MM)患者的临床特征及影响MM患者生存的相关预后因素。资料和方法:收集广西医科大学附属肿瘤医院2011年01月01日至2016年12月31日共收治164例初治的MM患者,并对这些患者的临床特征、实验室指标及治疗方案进行回顾性分析,同时对其中资料完整的84例患者使用Kaplan-Meier法进行生存分析,单因素分析使用Log-rank检验,多因素分析使用COX比例风险回归模型。结果:164例患者中位年龄58岁(25~89岁),男女比例1.6:1,D-S分期III期及ISS分期III期的患者比例分别为60.98%,57.46%;38例收集到完整免疫分型资料的MM患者以Ig G型为主,占55.2%,其次为轻链型,占21.1%。对84例具有完整随访资料的MM患者进行生存分析,单因素分析发现血清肌酐水平升高的患者PFS差于肌酐水平正常的患者,差异具有统计学意义(P=0.023)。血清白蛋白降低的患者PFS差于血清白蛋白正常的患者,差异具有统计学意义(P=0.000)。多因素分析发现血清白蛋白(HR=0.358,95%CI:0.187-0.685,P=0.002)是影响MM患者PFS的独立相关因素;血清肌酐(HR=2.055,95%CI:1.055-4.005,P=0.034)及白蛋白(HR=0.304,95%CI:0.136-0.680,P=0.004)均为影响MM患者OS的独立相关因素。结论:(1)本院164例多发性骨髓瘤患者中位发病年龄偏低,男性多见于女性;超过半数的患者初诊时分期偏晚;免疫分型以Ig G型为主。(2)血清白蛋白及血清肌酐可作为MM患者总生存期的独立预测因素。
[Abstract]:Objective: To investigate the clinical characteristics of Multiple myeloma (MM) patients and the related prognostic factors that affect the survival of MM patients. Data and methods: a total of 164 first treated MM patients were collected from 01 months of 2011 to 31 of December 2016 in the Affiliated Cancer Hospital of Guangxi Medical University. The treatment scheme was analyzed retrospectively, and 84 patients with complete data were analyzed by Kaplan-Meier method, single factor analysis using Log-rank test, and multifactor analysis using COX proportional hazard regression model. Results: 164 patients were 58 years of age (25~89 years), 1.6:1, D-S stage III and ISS stage III stage. The proportion of patients was 60.98%, 57.46%, 38 cases of MM patients with complete immunophenotyping data were mainly Ig G, 55.2%, followed by light chain type, and 84 cases of MM patients with complete follow-up data were analyzed by 21.1%.. The single factor analysis found that the patients with elevated serum creatinine level were worse than those with normal creatinine level. The difference was statistically significant (P=0.023). The PFS of serum albumin decreased in patients with normal serum albumin, the difference was statistically significant (P=0.000). The multifactor analysis found that serum albumin (HR=0.358,95%CI:0.187-0.685, P=0.002) was the independent dependent factor affecting PFS in MM patients; serum creatinine (HR=2.055,95%CI:1.055-4.005, P=0.) 034) and albumin (HR=0.304,95%CI:0.136-0.680, P=0.004) are the independent factors affecting OS in MM patients. Conclusion: (1) the median age of 164 cases of multiple myeloma in 164 patients in our hospital is lower, and more than half of the patients are late at first diagnosis; the immunization type is mainly Ig G. (2) serum albumin and serum creatinine can be found. As an independent predictor of the total survival of MM patients.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.3

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