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丰攀.新诊断多发性骨髓瘤患者的凝血指标与M蛋白及预后的相关性[J].内科急危重症杂志,2025,31(2):140-144
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| DOI：10.11768/nkjwzzzz20250209 |
| 中文关键词: 多发性骨髓瘤 凝血指标 M蛋白 预后 |
| 英文关键词: |
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| 摘要点击次数: 78 |
| 全文下载次数: 105 |
| 中文摘要: |
| 摘要 目的：探讨新诊断多发性骨髓瘤（NDMM）患者凝血指标与M蛋白类型及其定量的关系，以及凝血指标与预后的相关性。方法：回顾性分析157例NDMM患者的临床资料。根据患者存活状况分为生存组（100例）和死亡组（57例）。收集患者的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、D-二聚体（D-D）和M蛋白类型及定量检测结果，分析凝血指标变化与M蛋白类型及定量的相关性，以及凝血指标对患者预后的影响。 结果：PT、APTT、TT与M蛋白定量呈正相关， FIB与M蛋白定量呈负相关；IgA型的PT、APTT中位值分别为13.30s、34.60s，明显高于其余类型（P均＜0.05）；IgG型的TT中位值为19.20s，明显高于其余类型（P均＜0.05）。分析凝血指标与患者预后的相关性发现，生存组FIB水平低于死亡组，FIB的中位值分别为2.75g/L和3.31g/L（P=0.014）；生存组D-D水平低于死亡组，D-D的中位值分别为0.42mg/L和1.20mg/L（P＜0.001）。多因素分析结果显示，D-D水平是影响NDMM患者预后的独立危险因素。生存分析显示，D-D水平异常升高患者的总生存期和无进展生存期短于D-D水平正常的患者（P均＜0.05）。结论：NDMM患者的凝血功能与M蛋白定量及类型相关，FIB和D-D水平与患者预后相关，其中D-D是NDMM患者预后的独立危险因素。D-D水平高的NDMM患者总生存期和无进展生存期较短。凝血功能可作为预测预后的重要指标。 |
| 英文摘要: |
| Abstract bjective: To investigate the relationship between coagulation indexes and M-protein typing quantification in newly diagnosed multiple myeloma (NDMM) patients, as well as to assess the correlation between coagulation indexes and prognosis. Methods: Retrospective analysis was performed on the clinical data of 157 cases of NDMM. Patients were followed up for 24 months, with 100 survivors categorized as survival group and 57 deceased patients as the death group. The coagulation indicators, including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-Dimer (D-D), along with M protein type and quantity, were tested. The correlation between changes in coagulation indexes and M-protein type and quantity was analyzed,along with the impact of coagulation indexes on patients' prognosis. Results: PT, APTT, and TT were positively correlated with M protein quantity, while FIB was negatively correlated with M protein quantity. The median values of PT and APTT in the IgA type were 13.30s and 34.60s,respectively, both significantly higher than other types(all P<0.05).The median TT value in the IgG type was 19.20 s, which was significantly higher than that of the other types (all P< 0.05). Analysis of the correlation between coagulation indexes and patient prognosis revealed that, the survival group had significantly lower fibrinogen level than that of the death group, with the median level of fibrinogen being 2.75g/L and 3.31g/L respectively(P=0.014).The D-D level in the survival group was lower than that in the death group, with median D-D values of 0.42 mg/L and 1.20 mg/L respectively(P<0.001). The multivariate analysis demonstrated that the level of D-D was an independent risk factor affecting the prognosis of NDMM patients.Survival analysis showed that both progression-free survival and overall survival time were shorter in patients with elevated D-D levels than in those with normal D-D levels (P<0.05). Conclusion: In NDMM patients, coagulation function is highly correlated with M-protein quantity and type. Fibrinogen and D-D are associated with patient prognosis, with D-D being an independent prognostic factor for NDMM patients. NDMM patients with high D-D levels have shorter overall survival and progression-free survival. Coagulation function testing can server as important indicators for prognostic prediction. |
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