多发性骨髓瘤患者血清乳酸脱氢酶和C反应蛋白检测及临床意义

Determination and clinical significance of serum lactate dehydrogenase and C-reactive protein in patients with multiple myeloma

目的探讨在多发性骨髓瘤（MM）患者中血清乳酸脱氢酶（LDH）和C反应蛋白（CRP）水平测定的临床意义。方法分别采用速率法和散射比浊法测定2013年7月~2015年9月蚌埠医学院第一附属医院收治的32例MM患者（Ⅰ期8例、Ⅱ期11例、Ⅲ期13例）及20名健康体检者的血清LDH和CRP水平,分析LDH和CRP与疾病临床进展及预后的关系。结果 MM患者血清LDH和CRP水平高于健康体检者（P〈0.05）;LDH和CRP水平与患者年龄和性别均无相关性（P〉0.05）;不同分期MM患者LDH和CRP水平比较结果显示,LDH和CRP水平均为Ⅲ期明显高于Ⅱ期,Ⅱ期高于Ⅰ期,差异均有统计学意义（P〈0.05）;经2个周期的化疗后,患者LDH和CRP水平均较治疗前显著下降（P〈0.05）;MM患者的LDH水平与CRP呈明显正相关（P〈0.05）。结论血清LDH和CRP水平检测可作为MM诊断、分期和预后评估的相关指标。

Objective To investigate the clinical significance of serum lactate dehydrogenase（LDH） and C-reactive protein（CRP） in multiple myeloma（MM）. Methods The levels of serum LDH and CRP of 32 MM patients（8 cases in stage Ⅰ, 11 cases in stage Ⅱ and 13 cases in stage Ⅲ） and 20 healthy persons in the First Affiliated Hospital of Bengbu Medical College from July 2013 to September 2015 were measured by using velocity method and nephelometry assay. The relationships of LDH and CRP with clinical characteristics and prognosis were analyzed. Results The levels of serum LDH and CRP in MM patients were obviously higher than those of healthy persons（P〈0.05）. The levels of serum LDH and CRP in MM patients were not correlated with age and gender（P〉0.05）. The serum LDH and CRP of MM patients in different stages were respectively compared, which showed that the levels of LDH and CRP in stage Ⅲwere all higher than those of stage Ⅱ（P〈0.05）, which of stage Ⅱ were higher than those of stage Ⅰ, the differences were all statistically significant（P〈0.05）. The levels of serum LDH and CRP after two cycles of chemotherapy were significantly decreased compared with before treatment（P〈0.05）. The levels of LDH in patients with MM were positively correlated with CRP（P〈0.05）. Conclusion The detection of levels of serum LDH and CRP can be used as the relative indexes for diagnosis, classification and prognosis of patients with MM.