多发性骨髓瘤患者化疗期间感染炎症指标及FcγRIIA基因多态性与预后的关联

Association of infection-induced inflammatory markers and Fc-γRIIA gene polymorphism with prognosis in patients with multiple myeloma during chemotherapy

目的探究多发性骨髓瘤患者化疗期间感染炎症指标及FcγRIIA基因多态性与预后的关联.方法回顾性分析2020年1月-2023年2月山东大学齐鲁医院(青岛)55例多发性骨髓瘤化疗期间感染患者(研究组)与65例多发性骨髓瘤化疗期间未感染患者(对照组)的临床资料,研究组根据预后情况分为预后良好组(29例)和预后不良组(26例);检测患者静脉血中性粒细胞与淋巴细胞比值(NLR)、单核细胞和淋巴细胞比值(MLR)与血小板淋巴细胞比值(PLR)、降钙素原(PCT)、FcγRIIA基因多态性.结果研究组静脉血NLR、MLR、PLR、PCT均高于对照组;预后不良组静脉血NLR、MLR、PLR、血清PCT均高于预后良好组(P<0.05);研究组FcγRIIA-R型占比高于对照组,FcγRIIA-H型占比低于对照组(P<0.05);预后不良组FcγRIIA-R型占比高于预后良好组,FcγRIIA-H型占比低于预后良好组(P<0.05).结论临床多发性骨髓瘤患者化疗期间感染及不良预后与静脉血NLR、MLR、PLR、PCT水平异常升高有关,且FcγRIIA基因多态性与多发性骨髓瘤患者化疗期间感染的发生及不良预后有明显关系.

OBJECTIVE To investigate the association of inflammatory index of infection and FCRIIA gene polymorphism with prognosis of multiple myeloma patients during chemotherapy.METHODS Clinical data of 55 patients with multiple myeloma infected during chemotherapy(the study group)and 65 patients without infection during chemotherapy(the control group)admitted to Qilu Hospital of Shandong University(Qingdao)from Jan.2020 to Feb.2023 were retrospectively analyzed,and the patients in the study group were divided into a good prognosis group(29 cases)and a poor prognosis group(26 cases)according to prognosis.The NLR,MLR,PLR,serum PCT and gene polymorphisms of Fc-γRIIA in venous blood were detected.RESULTS The NLR,MLR,PLR,PCT in venous blood of the study group were higher than those of the control group.The NLR,MLR,PLR and serum PCT in venous blood of the poor prognosis group were higher than those of the good prognosis group(P<O.05).The Fc-γRIIA-R type in the study group was higher than that in the control group,while the Fc-γRIIAH type was lower than that in the control group(P<0.05).The percentage of Fc-γRIIA-R type in the poor prog-nosis group was higher than that in the good prognosis group,while the percentage of Fc-γRIIA-H type was lower than that in the good prognosis group(P<0.05).CONCLUSION Infection and poor prognosis of patients with multiple myeloma during chemotherapy were associated with abnormally elevated levels of NLR,MLR,PLR in venous blood and serum PCT,and the polymorphism of Fc-γRIIA gene was significantly associated with infection and poor prognosis of patients with multiple myeloma during chemotherapy.