血清铁蛋白水平在初治多发性骨髓瘤患者中的临床意义

发布时间：2018-04-13 13:14

  本文选题：血清铁蛋白 + 多发性骨髓瘤　； 参考：《南昌大学》2016年硕士论文

【摘要】：背景与目的:多发性骨髓瘤(Multiple myeloma,MM)是一种多发于中老年的恶性肿瘤,临床症状、细胞遗传学表现多种多样,其预后因素众多,单一因素不足以决定其预后,需多个因素联合分析对患者进行分期和危险分层。因此,探索新的预后因素在MM疾病的诊疗中意义重大。血清铁蛋白(Serum Ferritin,SF)作用广泛,跟铁贮存、炎症及肿瘤有关。SF可作为血液肿瘤的一个不良预后因素,有助于肿瘤负荷和疗效监测。本文通过观察初治MM患者SF水平,分析SF水平与MM患者临床特征、疗效的关系,探索SF在MM诊断、疗效监测中的重要意义。方法:收集南昌大学第一附属医院2009年1月到2015年12月期间住院的多发性骨髓瘤患者病例资料87例,所有患者均为初治病例。分析SF水平与初治MM患者各项临床特征及预后的关系。应用SPSS 18.0软件,计量资料统计描述:服从正态分布时采用平均数(`X±S),不服从正态分布时采用中位数;两样本均数比较,若两样本均服从正态分布时采用t检验,否则采用非参数秩和检验;相关分析采用Spearman检验。相关分析以P0.01为差异具有统计学意义,其他以P0.05为差异具有统计学意义。结果:87例患者中男性有55例,女性有32例,平均年龄为58.32±10.73岁。骨痛和头晕乏力为患者初诊时最常见的症状,分别为39%、18.3%,大部分患者就诊时为中度贫血,占43.7%。72.4%患者处于Durie-Salmon(DS)Ⅲ期,47.1%患者处于International Staging System(ISS)Ⅲ期,IgG型最常见,占46%。采用Spearman多元相关分析,显示SF与血肌酐、血乳酸脱氢酶(Lactate Dehydrogenase,LDH)、C反映蛋白(C-Reactive Protein,C RP)、血β2微球蛋白(β2-microglobulin,β2-Mg)、分期、疗效呈直线相关。SF较高组与较低组比较在年龄、性别、血红蛋白、血小板、淋巴细胞绝对数、白蛋白、骨髓浆细胞比例分布上无明显差异,在血钙、血LDH、血肌酐、CRP、血β2-Mg、分型、分期、疗效分布上具有差异。结论:1、多发性骨髓瘤中SF升高的原因可能与肿瘤相关的炎症状态有关。2、SF可反映多发性骨髓瘤肿瘤负荷,可用于多发性骨髓瘤疗效监测、预后评估。
[Abstract]:Background & objective: multiple myeloma (MM) is a kind of malignant tumor in middle and old age. Its clinical symptoms, cytogenetic manifestations and prognostic factors are various, and the single factor is not enough to determine its prognosis.Multiple factors are needed for staging and risk stratification.Therefore, exploring new prognostic factors is of great significance in the diagnosis and treatment of MM disease.Serum ferritin (Serum Ferritinus SF) has a wide range of effects. SF, which is related to iron storage, inflammation and tumor, can be used as a poor prognostic factor for blood tumors, which is helpful for monitoring tumor load and curative effect.By observing the level of SF in newly treated MM patients and analyzing the relationship between SF level and the clinical characteristics and curative effect of MM patients, the significance of SF in the diagnosis and monitoring of MM was explored.Methods: 87 patients with multiple myeloma were collected from January 2009 to December 2015 in the first affiliated Hospital of Nanchang University.To analyze the relationship between SF level and clinical features and prognosis of newly treated MM patients.Using SPSS 18.0 software, the statistical description of the measurement data: the average (`X 卤S) when taking the normal distribution, the median when not using the normal distribution, the comparison of the mean of the two samples, if the two samples are taken from the normal distribution, the t test is used.Otherwise, nonparametric rank sum test was used, and Spearman test was used for correlation analysis.Correlation analysis with P0.01 as the difference was statistically significant, other P0.05 as the difference was statistically significant.Results there were 55 males and 32 females in the 87 cases. The average age was 58.32 卤10.73 years.Bone pain and dizziness were the most common symptoms in the first visit, which were 39 and 18.3.The majority of the patients were moderate anemia, accounting for 43.7.72.4% of the patients were in Durie-Salmon DS) stage 鈪，

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