多发性骨髓瘤患者血清β2-MG、TNF-α、LDH的水平变化及与预后相关性

Changes of serum β2-MG,TNF-α and LDH levels in patients with multiple myeloma and their correlation with prognosis

目的 分析多发性骨髓瘤患者血清β2-微球蛋白(β2-MG)、肿瘤坏死因子-α(TNF-α)、乳酸脱氢酶(LDH)的水平变化及与预后相关性。方法 选取2019年1月至2022年1月南阳市中心医院收治多发性骨髓瘤患者122例为研究对象(观察组),根据国际分期系统(ISS)分期:Ⅰ期34例,Ⅱ期46例,Ⅲ期42例;另选取同期于本院行体检且各项正常的健康人群118名为对照组。检测两组及多发性骨髓瘤患者不同ISS分期的血清β2-MG、TNF-α、LDH表达。分析影响多发性骨髓瘤患者预后情况的单因素,采用多元Logistic回归分析影响多发性骨髓瘤患者预后不良的危险因素。结果 观察组β2-MG、TNF-α、LDH水平均显著高于对照组,差异具有统计学意义(P<0.05)。β2-MG、TNF-α、LDH水平:Ⅲ期>Ⅱ期>Ⅰ期,差异具有统计学意义(P<0.05)。预后良好组101例,预后不良好组21例。两组性别、年龄、ISS分期、骨髓浆细胞比例、C反应蛋白、白蛋白及血小板比较差异无统计学意义(P<0.05)。两组血肌酐、中性-淋巴细胞比值、β2-MG、TNF-α及LDH比较差异具有统计学意义(P<0.05)。经多元Logistic回归分析可知,血肌酐、中性-淋巴细胞比值、β2-MG、TNF-α及LDH为影响多发性骨髓瘤患者预后不良的独立危险因素(P<0.05)。结论 血清β2-MG、TNF-α、LDH在多发性骨髓瘤中呈上升表达,且与患者预后存在紧密联系,可为后续治疗提供一定参考价值。

Objective To analyze the changes of serum β2-microglobulin(β2-MG),tumor necrosis factor-α(TNF-α),lactate dehydrogenase(LDH)levels and their correlation with prognosis in patients with multiple myeloma. Methods A total of 122 patients with multiple myeloma admitted to Nanyang Central Hospital from January 2019 to January 2022 were selected as the study subjects(observation group). According to the International Staging System(ISS):34 cases of stage I,46 cases of stageⅡ,and 42 cases of stageⅢ.Another 118 healthy people who underwent physical examination in our hospital during the same period with normal conditions were selected as the control group. The expressions of serum β2-MG,TNF-α and LDH in two groups and multiple myeloma patients at different ISS stages were detected. The single factors influencing the prognosis of multiple myeloma patients were analyzed,and the risk factors influencing poor prognosis of multiple myeloma patients were analyzed by Multiple Logistic regression. Results The levels of β2-MG,TNF-αand LDH in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). The levels of β2-MG,TNF-α and LDH:stage Ⅲ > stage Ⅱ > stage Ⅰ,the difference was statistically significant(P>0.05). There were 101 cases in the good prognosis group and 21 cases in the poor prognosis group. There were no significant differences in gender,age,ISS stage,bone marrow plasma cell ratio,C-reactive protein,albumin and platelet between the two groups(P<0.05). There were statistically significant differences in serum creatinine,neutrophil-to-lymphocyte ratio,β2-MG,TNF-αand LDH between the two groups(P<0.05). Multiple Logistic regression analysis showed that serum creatinine,neutrophil-to-lymphocyte ratio,β2-MG,TNF-α and LDH were independent risk factors for poor prognosis in patients with multiple myeloma(P<0.05). Conclusion Serum β2-MG,TNF-α,and LDH are upexpressed in multiple myeloma,and are closely related to the prognosis of patients,which can provide certain reference value for subsequent treatment.