[多发性骨髓瘤患者血脂水平及其预后意义]。

Ming-Zhen Chen, Xue-Ya Zhang, Mei-E Wang, Rong-Fu Huang, Chun-Mei Fan
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引用次数: 1

摘要

目的:探讨多发性骨髓瘤(MM)患者血脂水平及其预后意义。方法:选取2012年1月~ 2021年4月本院新诊断MM患者87例,健康对照87例。比较MM患者与健康对照者的血脂水平。分析两组患者血脂水平在性别、年龄、血红蛋白(Hb)、白蛋白(ALB)、血小板(PLT)、β2-微球蛋白(β2-MG)、骨髓浆细胞比(BMPC)、不同免疫类型、不同ISS分期、化疗前后的差异。采用单因素和COX多因素回归分析,分析血脂指标等临床参数对mm预后的影响。MM患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1 (Apo A1)、载脂蛋白B (Apo B)水平均显著低于健康对照组(P0.05),Ⅲ期显著低于Ⅱ期、Ⅰ期(P2-MG、BMPC、LDL-C和Apo B影响MM的预后,多因素分析显示BMPC和Apo B是影响MM预后的独立因素。结论:MM患者血清胆固醇水平降低,低胆固醇血症与疾病的分型和分期有关。随着病情的好转,血清胆固醇水平升高,血清载脂蛋白B水平低预示预后不良。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Serum Lipid Levels and Their Prognostic Significance in Patients with Multiple Myeloma].

Objective: To investigate the serum lipid levels and their prognostic significance in patients with multiple myeloma (MM).

Methods: A total of 87 newly diagnosed MM patients and 87 healthy controls in our hospital from January 2012 to April 2021 were selected. Serum lipid levels were compared between MM patients and healthy controls. The differences of serum lipid levels in patients among two groups of sex, age, hemoglobin (Hb), albumin (ALB), platelet (PLT), β2-microglobulin (β2-MG) and bone marrow plasma cell ratio (BMPC), different immune types, different ISS stages, before and after chemotherapy were analyzed. Univariate and COX multivariate regression analysis were used to analyze the influence of clinical parameters such as serum lipid indexes on prognosis of MM.

Results: The serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) in MM patients were significantly lower than those in healthy controls (P<0.05). Anemia, low protein and low PLT in patients were related to low cholesterol. The levels of TC, LDL-C, HDL-C, Apo A1 and Apo B in patients with low Hb and ALB were significantly lower than those in patients with high Hb and ALB (P<0.05). The Apo B level of low PLT patients was significantly lower than that of high PLT patients (P<0.05). The levels of TC, LDL-C, HDL-C, Apo A1 and Apo B in patients with different immune types were significantly different, the above indexes of IgA type were significantly lower than IgG type(P<0.05), IgG type were significantly lower than light chain type(P<0.05), double clone type were significantly lower than light chain type (P<0.05). The levels of TC, LDL-C, and Apo B in patients with different ISS stages were significantly different, stage Ⅱ were lower than those of stage Ⅰ (P>0.05), stage Ⅲ were significantly lower than those of stage Ⅱ and stageⅠ(P<0.05). The levels of TC, TG, LDL-C, HDL-C, Apo A1 and Apo B in patients after chemotherapy were significantly higher than those before chemotherapy (P<0.05). Univariate analysis showed that Hb, PLT, β2-MG, BMPC, LDL-C and Apo B affected the prognosis of MM. Multivariate analysis showed that BMPC and Apo B were independent factors affecting the prognosis of MM.

Conclusion: The serum cholesterol level is decreased in MM patients, and hypocholesterolemia is related to the classification and staging of the disease. With the improvement of the disease, the serum cholesterol level is increased, and low serum Apo B level predicts a poor prognosis.

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