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目的:检测多发性骨髓瘤(multiple myeloma,MM)病人不同发展阶段血同型半胱氨酸(homocysteine,Hcy)、β2微球蛋白(β2-microglobulin,β2-MG)及血沉(erythrocyte sedimentation rate,ESR)水平,以探讨这些因子在MM的诊断、治疗及预后判断中的临床意义。方法:选择MM病人30例,正常对照组20例,测定其血Hcy、β2-MG及ESR水平对结果比较分析,并对MM病人进行治疗前、后不同阶段进行动态检测。结果:(1)AL组初诊时血Hcy、β2-MG及ESR均明显升高,与正常对照组比较有显著性差异(P<0.05、P<0.05及P<0.01);(2)初诊时MM病人血浆Hcy、β2-MG及ESR水平在不同分期之间差异有统计学意义(P<0.05及P<0.01);(3)经过4个疗程的治疗后,达到完全缓解[包括完全缓解(CR)和非常好的部分缓解(VGPR)]时,血Hcy、β2-MG及ESR基本恢复正常,与正常对照组比较无显著差异(P>0.05);(4)经过4个疗程的治疗后,未达到缓解[包括部分缓解(PR)、疾病稳定(SD)、病情进展(PD)和完全缓解后复发]时,上述因子与治疗前比较差异无统计学意义(P>0.05);(5)相关性分析显示,MM病人组血Hcy水平与β2-MG及ESR均为正相关[(r=0.71,P<0.01)和(r=0.45,P<0.05)]。结论:动态监测MM病人血Hcy、β2-MG及ESR水平,可作为MM病情进展、疗效过程及预后判断的重要参考指标。
Objective: To detect the levels of homocysteine (Hcy), β2-microglobulin (β2-MG) and erythrocyte sedimentation rate (ESR) in patients with multiple myeloma (MM) ) Levels to explore the clinical significance of these factors in the diagnosis, treatment and prognosis of MM. Methods: Thirty patients with MM and 20 normal controls were enrolled in this study. The levels of Hcy, β2-MG and ESR in blood were measured and compared with those of MM patients. The dynamic changes of MM patients at different stages before and after treatment were analyzed. Results: (1) The blood levels of Hcy, β2-MG and ESR in AL group were significantly higher than those in normal control group (P <0.05, P <0.05 and P <0.01) The plasma levels of Hcy, β2-MG and ESR in MM patients were significantly different between different stages (P <0.05 and P <0.01). (3) After 4 courses of treatment, complete remission [including complete remission (P> 0.05); (4) After 4 courses of treatment, the serum levels of Hcy, β2-MG and ESR returned to normal after treatment with CR, CR and VGPR; (P> 0.05); (5) No significant difference was found between the above factors and before treatment (P> 0.05) ) Correlation analysis showed that there was a positive correlation between serum homocysteine level and β2-MG and ESR in MM patients (r = 0.71, P <0.01) and (r = 0.45, P <0.05). Conclusion: The dynamic monitoring of blood levels of Hcy, β2-MG and ESR in patients with MM can be used as an important reference index for progression of MM, curative effect and prognosis.