纤维蛋白原与多发性骨髓瘤患者预后的关系

Pre-treatment fibrinogen level provides prognostic information in multiple myeloma

目的:初步探讨外周血纤维蛋白原(fibrinogen,FIB)在多发性骨髓瘤(multiple myeloma,MM)患者预后中的价值。方法:以84例初诊多发性骨髓瘤患者为研究对象,根据凝血功能结果,计算得出FIB的均值。以均值为临界值,将骨髓瘤患者分为低FIB组(FIB≤3.51 g/L)和高FIB组(FIB>3.51 g/L),分析两组患者在性别、年龄、国际分期标准(ISS分期)、血红蛋白水平(Hb)、血清肌酐(Cr)、骨髓瘤类型、治疗方案、白蛋白水平(ALB)、血清β2微球蛋白水平(β2-MG)、骨髓中瘤细胞比例和总生存期(OS)方面的差异。结果:与低FIB组相比,高FIB组男性比例更高,β2-MG水平偏高,差异有统计学意义(P<0.05);且高FIB组中位生存时间明显缩短(χ^2=4.251,P<0.05)。单因素及多因素分析结果显示,FIB>3.51 g/L是影响多发性骨髓瘤患者预后的独立危险因素之一(P<0.05)。结论:多发性骨髓瘤患者外周血FIB升高提示预后不良,是影响患者预后的一个独立危险因素。

Objective:To explore the value of peripheral blood fibrinogen (FIB) in the prognosis of patients with multiple myeloma (MM).Methods:The study was performed on 84 patients with multiple myeloma,according to the results of coagulation function,the mean value of FIB was calculated,and the patients were divided into low FIB group (FIB≤3.51g/L) and high FIB group (FIB>3.51g/L).And analysed the gender,age,international staging standard (ISS),hemoglobin level,serum creatinine (Cr),myeloma type,treatment,serum globulin,albumin level,the proportion of tumor cells in bone marrow and overall survival (OS) differences in two groups.Results:Compared with the low FIB group,the higher FIB group had a higher proportion of males,and the level of β2-MG was higher,and the difference was statistically significant ( P <0.05),and the median survival time of the high FIB group was significantly shortened (χ^2=4.251, P <0.05).COX single factor and multivariate analysis showed that FIB>3.51g/L was one of the independent risk factors affecting the prognosis of patients with multiple myeloma ( P <0.05).Conclusion:Peripheral blood FIB in patients with multiple myeloma indicates poor prognosisand is an independentprognosis factor for MM.