血清瘦素在多发性骨髓瘤患者中的应用价值研究

Investigation of Clinical Value of Serum Leptin in Patients with Multiple Myeloma.

目的研究多发性骨髓瘤(MM)患者血清瘦素水平,探讨其与MM的关系。方法收集我院2018年1月至2020年10月初诊的MM患者60例,同时选取60例健康人做对照,分别检测血清瘦素表达水平,并检测MM患者血钙、β2微球蛋白、血轻链、乳酸脱氢酶和C反应蛋白水平。结果MM患者与健康对照组血清瘦素比较,两组差异有统计学意义(t=3.174,P<0.05);BMI对MM患者和健康对照组血清瘦素水平没有影响,差异无统计学意义(P>0.05)。轻链型瘦素水平高于IgG型(q=3.845,P=0.04),IgG型高于IgA型(q=4.35,P=0.02),IgA高于不分泌型(q=4.838,P=0.000)。MM患者瘦素水平DSⅢ期高于DSⅡ期,DSⅡ期高于DSⅠ期(q=3.987、q=4.587,P<0.05);MM患者CRP水平DSⅢ期高于DSⅠ、Ⅱ期(q=5.157、q=4.367,P<0.05)。MM患者血清瘦素水平与血钙、β2微球蛋白、血轻链、乳酸脱氢酶、CRP呈正相关(R=0.419、0.692、0.623、0.405、0.677)。绘制ROC曲线发现,血清瘦素ROC曲线面积为0.764,敏感度70.5%,特异度74.6%。MM患者治疗前后缓解患者血清瘦素水平比较,差异有统计学意义(t=3.361,P=0.001);未缓解患者治疗前后比较,差异无统计学意义(t=1.012,P=0.3)。结论血清瘦素可以作为临床诊断和监测MM临床治疗效果的可靠指标。

Objective To study the serum leptin levels in patients with multiple myeloma and its relationship with multiple myeloma.Methods A total of 60 patients with multiple myeloma(MM)newly diagnosed in the Hospital of Chengde Medical College from^(2)018 to 2020 were collected,and 60 healthy subjects were selected as controls.Serum leptin expression levels were detected,while serum calcium,β2 microglobulin,blood light chain,lactate dehydrogenase and C-reactive protein levels were detected in MM patients.Results The serum leptin of multiple myeloma patients was compared with that of healthy control group(t=3.174,P<0.05),and the difference between the two groups was statistically significant.Body mass index had no impact on serum leptin level in MM patients and healthy control group,and the difference was not statistically significant(P>0.05).The leptin level of light chain type was higher than that of IgG type(q=3.845,P=0.04),IgG type was higher than that of IgA type(q=4.35,P=0.02),and IgA type was higher than that of non-secreted type(q=4.838,P=0.000).Multiple myeloma leptin levels in patients of DSⅢperiod were higher than of DSⅡperiod,those of DSⅡperiod were higher than those of DSⅠperiod(q=3.987,q=4.587,P<0.05);the CRP level of DSⅢperiod was higher than that of DSⅠ,Ⅱperiod in MM group(q=5.157,q=4.367,P<0.05).the sensitivity was 70.5%,and the specificity was 74.6%.Serum leptin was positively correlated with serum calcium,β2 microglobulin,serum light chain,lactate dehydrogenase and CRP in multiple myeloma(r=0.419,0.692,0.623,0.405,0.677).The ROC curve showed that the ROC area of serum leptin was 0.764,Serum leptin of patients in remission of multiple myeloma before and after treatment was compared(t=3.361,P=0.001),and the difference was statistically significant.Before and after treatment(t=1.012,P=0.3),there was no statistically significant difference of leptin in patients not in remission.Conclusion Serum leptin can be employed as a reliable index for clinical diagnosis and monitors the clinical treatment effect of multiple myeloma.