多发性骨髓瘤患者临床特点及总体生存情况的影响因素

Clinical Characteristics and Influencing Factors of Overall Survival in Patients with Multiple Myeloma

目的观察多发性骨髓瘤(MM)患者临床特征及总体生存情况,并分析影响MM患者生存情况的相关因素。方法选取2016年1月至2019年1月河南科技大学第一附属医院收治的100例MM患者为研究对象,治疗前进行相关检测并记录所有患者的临床特征,后给予患者一般治疗及规律性化疗,同时开展36个月的随访,以患者病死或随访截止时间为观察终点,统计患者总体生存情况。研究人员设计患者基线资料表,调查并记录研究所需资料,将可能的因素纳入,经Cox回归分析找出MM患者生存结局的影响因素。结果100例MM患者中,疾病类型以IgG型为主,骨髓浆细胞百分比多大于30%,D-S分期集中于Ⅱ期、Ⅲ期,并发症状较多,且以贫血为主。观察期间,100例MM患者中病死42例(42.00%)。病死组患者疾病D-S分期、伴粒细胞缺乏症、血清Hcy、UA水平与存活组患者比较,差异有统计学意义(P<0.05)。两组间其他基线资料比较,差异无统计学意义(P>0.05)。经Cox回归分析,结果显示疾病D-S分期Ⅲ期、伴粒细胞缺乏症、血清Hcy、UA水平高是MM患者不良生存结局危险因素(HR>1,P<0.05)。结论MM好发于老年人群,患者疾病类型以IgG型为主,骨髓浆细胞百分比多大于30%,D-S分期集中于Ⅱ期、Ⅲ期,并发症状较多,且以贫血为主;MM患者存在一定的病死风险,且其影响因素可能为疾病D-S分期Ⅲ期、伴粒细胞缺乏症、血清Hcy、UA水平高。

Objective To observe the clinical characteristics and overall survival of patients with multiple myeloma(MM),and to analyze the related factors affecting the survival condition of patients with MM.Methods A total of 100 MM patients from the First Affiliated Hospital of Henan University of Science and Technology from January 2016 to January 2019 were selected as the research subjects.Relevant tests were carried out before treatment,and the clinical characteristics of all patients were recorded.After that,the patients were given general treatment and regular chemotherapy,and followed up for 36 months.The overall survival of patients was counted with the end point of death or follow-up.The researchers designed the baseline data sheet of patients,investigated and recorded the data required for the study,included the possible factors,and found out the influencing factors of survival outcome of MM patients by Cox regression analysis.Results Among the 100 MM patients,the type of disease was mainly IgG,and the percentage of bone marrow plasma cells was more than 30%.Durie and Salmon(D-S)stage was concentrated in stageⅡandⅢ,with more symptoms and anemia.During the observation period,42 of 100 MM patients died(42.00%).Compared disease D-S stage,agranulocytosis,serum homocysteine(Hcy)and uric acid(UA)levels between the dead group and the survival group,the differences were statistically significant(P<0.05).There was no statistical significant difference in other baseline data between the two groups(P>0.05).The results of Cox regression analysis showed that D-S stageⅢ,agranulocytosis,high serum Hcy and UA levels were risk factors for poor survival outcomes in MM patients(HR>1,P<0.05).Conclusion MM tends to occur in the elderly.The disease type of patients is mainly IgG type,and the percentage of bone marrow plasma cells is more than 30%.The D-S stage is concentrated in stageⅡandⅢ,with more concurrent symptoms and anemia.MM patients have a certain risk of death,and the influencing factors may be D-S stageⅢ,granulocyte deficiency,and high serum Hcy and UA levels.