硼替佐米对多发性骨髓瘤患者认知功能的影响及与血清脑源性神经营养因子的相关性

Effect of Bortezomib on Cognitive Function in Patients with Multiple Myeloma and its Correlation with Serum Brain-derived Neurotrophic Factor

目的探索硼替佐米对多发性骨髓瘤(MM)患者认知功能的影响及与血清脑源性神经营养因子(BDNF)水平变化的相关性。方法选择2021年8月-2022年8月收治的MM患者90例作为观察组,另选同期健康体检者30名作为健康对照组。观察组根据是否采用硼替佐米化疗以及化疗疗程分为初诊MM组(30例)、化疗疗程≤4组(30例)和化疗疗程>4组(30例)。比较健康对照组、初诊MM组、化疗疗程≤4组和化疗疗程>4组蒙特利尔认知评估量表(MoCA)评分和血清BDNF水平,分析观察组患者的MoCA评分与血清BDNF水平的相关性。结果观察组MoCA评分和血清BDNF水平均低于健康对照组(P<0.05);而初诊MM组MoCA评分与血清BDNF水平均高于化疗疗程≤4组和化疗疗程>4组(P<0.05),且化疗疗程>4组MoCA评分和血清BDNF水平低于化疗疗程≤4组(P<0.05);Pearson相关性分析显示,观察组MoCA评分与血清BDNF水平呈正相关(r=0.588)。结论MM患者在化疗前存在一定程度的认知功能损害。硼替佐米化疗以及化疗时间的延长可使患者的认知障碍进一步加重。硼替佐米化疗加重MM患者认知障碍与其血清BDNF水平下降具有一定的相关性。

Objective To explore the effect of bortezomib on cognitive function in patients with multiple myeloma(MM)and its correlation with serum brain-derived neurotrophic factor(BDNF)levels.Methods A total of 90 patients with MM from August 2021 to August 2022 were selected as the observation group,and 30 healthy people in the same period were selected as the healthy control group.The observation group was divided into newly diagnosed MM group(30 cases),chemotherapy course≤4 group(30 cases)and chemotherapy course>4 group(30 cases)according to whether bortezomib chemotherapy was used and the course of chemotherapy.The Montreal Cognitive Assessment(MoCA)score and serum BDNF level were compared among the healthy control group,newly diagnosed MM group,chemotherapy course≤4 group and chemotherapy course>4 group.The correlation between MoCA score and serum BDNF level in the observation group was analyzed.Results The MoCA score and serum BDNF level in the observation group were lower than those in the healthy control group(P<0.05).MoCA score and serum BDNF level in newly diagnosed MM group were higher than those in chemotherapy course≤4 group and chemotherapy course>4 group(P<0.05),and the MoCA score and serum BDNF level in the chemotherapy course>4 group were lower than those in the chemotherapy course≤4 group(P<0.05).Pearson correlation analysis showed that MoCA score was positively correlated with serum BDNF level in the observation group(r=0.588).Conclusion MM patients have a certain degree of cognitive impairment before chemotherapy.Bortezomib chemotherapy and the prolongation of chemotherapy time can further aggravate the cognitive impairment of patients.Bortezomib chemotherapy aggravates cognitive impairment in MM patients and has a certain correlation with the decrease of serum BDNF level.