常规生化检查在初诊多发性骨髓瘤患者中的应用价值

摘要

目的 探讨常规生化指标在多发性骨髓瘤(MM)中的应用价值.方法 回顾性分析天津市第三中心医院2004年1月至2010年5月收住院的63例初诊MM患者的临床资料,根据同时检测的血清清蛋白水平对血钙进行校正,然后对MM患者进行Durie-Salmon(DS)分期,分析常规生化指标与MM分期的关系.结果 经血清钙校正后Ⅰ、Ⅱ、Ⅲ期MM患者分别为15例、9例和39例,各期之间球蛋白、清蛋白、β2-微球蛋白及血沉的差异均具有统计学意义(P<0.05),而乳酸脱氢酶和C反应蛋白的差异没有统计学意义(P>0.05).β2-微球蛋白与C反应蛋白呈正相关,与清蛋白、乳酸脱氢酶、血沉则无明显相关(P>0.05).结论 球蛋白、清蛋白和β2-微球蛋白的浓度在MM不同分期之间呈梯度分布,可以为MM分期提供辅助信息,反映MM的病情严重程度.%Objective To investigate the clinical application value of routine biochemical tests in multiple myeloma (MM). Methods Clinical data of 63 cases of patients with preliminary diagnosis of MM from the Third Central Hospital of Tianjian between January 2004 and May 2010 were retrospectively analyzed. The serum level of calcium was corrected by the serum level of albumin, measured simultaneously. Staging was performed according to Durie and Salmon staging system. The relationship between routine biochemical tests and MM stages was analyzed. Results The cases of patients with MM at I , Ⅱ or Ⅲ stage were 15,9 and 39, respectively. Differences of globulin,albumin,|32-microglobulin and erythrocyte sedimentation rate among patients at different stages were statistically significant(P<0. 05),but difference of lactate dehydrogenase and C-reactive protein were not significant(P>0. 05). Serum level of (32-microglobulin was positively correlated with C-reactive protein,but not correlated with lactate dehydrogenase and erythrocyte sedimentation rate (P>0. 05). Conclusion The concentration of globulin,albumin and (32-microglobulin in patients with MM at different stages presented gradient changes, which could provide supplementary information for MM staging and reflect the severity of MM.