意义未明的单克隆免疫球蛋白病血栓栓塞并发症的研究进展

摘要

意义未明的单克隆免疫球蛋白病(MGUS)患者静脉血栓栓塞(VTE)的过度危险已有报道.群体研究MGUS 1年-、5年-和10年-静脉血栓形成(VT)的危险性.深静脉血栓形成(DVT)和肺栓塞(PE)危险、动脉血栓形成、冠状动脉和脑血管事件的危险均增加.IgM MGUS 患者并无血栓形成增加的危险,而IgG/IgA MGUS患者静脉血栓形成的危险增加4倍.血栓形成的危险不随诊断时M-蛋白浓度(＞10.0g/L或＜10.0g/L)而变动.伴/不伴血栓形成的MGUS患者血栓形成的危险未超过MM或原发性巨球蛋白血症(WM).伴比不伴血栓形成的MGUS患者其5年和10年生存率差.%Excess risk of venous thromboembolism has been observed among patients with monoclonal gammopathy of undetermined significance ( MGUS ). Using population - based data from Sweden assessed the risks of venous and arterial thrombosis in MM and MGUS patients. At 1, 5, and 10 years after MGUS diagnosis, there was an increased risk of venous thrombosis, DVT and PE, arterial thrombosis, coronary artery disease and cerebrovascular events increased. IgG/IgA ( but not IgM ) MGUS patients had increased risks for venous and arterial thrombosis. Risks for thrombosis did not vary by M - protein concentration ( ＞ 10.0 g/L or ＜ 10.0 g/L ) at diagnosis. MGUS patients with ( vs without ) thrombosis had no excess risk of MM or Waldenstrom macroglobulinemia. MGUS patients with thrombosis had inferior survival compared with MGUS patients without thrombosis at 5 and 10 years.