血钙、血清β_2微球蛋白和调节性T细胞在多发性骨髓瘤患者初诊中的临床价值

Clinic value of serum calcium,serum β_2 microglobulin and regulatory T cells in patients with newly diagnosed multiple myeloma

目的探讨血钙、血清β2微球蛋白和调节性T细胞检测在多发性骨髓瘤(MM)患者初诊中的临床价值。方法选取60例MM初诊患者作为MM组,并于同期选取60例健康人员作为健康组,收集2组受检者的白细胞计数、血红蛋白、血小板计数、血清白蛋白、血钙、C反应蛋白、β2微球蛋白、调节性T细胞检测数据,并比较不同分期的MM患者、治疗有效组和治疗无效组上述指标的差异性。结果 MM组患者血红蛋白、血清白蛋白、血小板计数均明显低于健康组(P均<0. 05),血钙、C反应蛋白、β2微球蛋白水平及调节性T细胞比例均明显高于健康组(P均<0. 05)。不同分期的MM患者间除血小板计数无显著差异外(P> 0. 05),其余指标的比较差异均有统计学意义(P均<0. 05)。MM治疗有效组的血红蛋白水平明显高于治疗无效组(P <0. 05),血钙、C反应蛋白、β2微球蛋白、调节性T细胞比例明显低于治疗无效组(P均<0. 05),且多因素Logistic回归分析发现,血钙、β2微球蛋白和调节性T细胞是MM患者预后的独立危险因素。结论血钙、血清β2微球蛋白和调节性T细胞是影响MM患者预后的独立危险因素,这为MM患者的免疫调节和初诊治疗中的针对性用药提供了依据。

Objective It is to investigate the clinical value of serum calcium,serumβ2 microglobulin and regulatory T cells in patients with newly diagnosed multiple myeloma(MM).Methods Sixty cases of patients with newly diagnosed MM were selected as MM group,and 60 healthy persons in the same period were selected as healthy control group.The determination data of white blood cell count,hemoglobin,serum albumin,serum calcium,C-reaction protein andβ2 microglobulin and regulatory T cells were collected from the two groups,and the differences in the clinical indexes above were compared between MM patients with different stages,the effective treatment group and ineffective treatment group.Results The hemoglobin,serum albumin and platelet count of MM group were significantly lower than that of healthy group(P<0.05),while the levels of blood calcium,C-reactive protein,β2 microglobulin and regulatory T cells ratio were significantly higher than those in healthy group(P<0.05).There was no significant difference in platelet count between MM patients with different stages(P >0.05),but the other indicators were statistically significant(P<0.05).The hemoglobin,serum calcium,C-reactive protein,β2 microglobulin and regulatory T cells ratio in the effective treatment group were significantly lower than those in ineffective treatment group(P<0.05).Multi factor logistic regression analysis showed that independent risk in prognosis factors of patients with MM were serum calcium,serumβ2 microglobulin and regulatory T cells.Conclusion Serum calcium,β2 microglobulin and regulatory T cells were independent prognostic factors in MM,which provides a scientific basis for the regulation immunity and the treatment of patients with newly diagnosed MM.