摘要
目的 分析不同β2微球蛋白（β2-MG）水平合并或不合并肾功能异常的初诊多发性骨髓瘤（MM）患者的生存情况,探讨肾功能对β2微球蛋白作为MM预后因素的影响.方法 对1999年2月至201 3年10月666例初诊MM患者临床资料进行回顾性分析,以血肌酐＜177 μmol/L为肾功能相对正常组,血肌酐≥177 μmol/L为肾功能异常组,分析不同β2-MG水平及肾功能状态患者总生存（OS）情况.结果 666例患者中男416例,女250例,中位年龄58（25～86）岁.β2-MG＜3.5、3.5～＜5.5及≥5.5 mg/L患者分别为208、173及285例,其OS时间分别为85.75 （95％ CI 70.99～100.50）、47.25 （95％ CI 40.98～53.53）及35.05（95％CI30.75～39.35）个月,差异有统计学意义（P＜0.01）.肾功能相对正常与肾功能异常患者OS时间分别为64.67（95％CI56.57～72.77）及32.74（95％CI27.74～37.73）个月,差异有统计学意义（P＜0.01）.在β2-MG≥5.5 mg/L的患者中,肾功能相对正常与肾功能异常患者OS时间分别为37.25（95％ CI 31.45～43.06）个月、32.55（95％ CI26.26～38.83）个月,差异无统计学意义（P=0.142）.结论 高水平β2-MG、肾功能异常MM患者生存时间较短,是否合并肾功能异常并未改变β2-MG作为MM国际分期系统预后因素的影响.
Objective To investigate the influence of renal function on the level of β2-microglobulin （β2-MG） as prognostic factor in newly diagnosed multiple myeloma （MM） patients,and to analyze the overall survival （OS） in different level of β2-MG with relatively normal or abnormal renal function in MM patients.Methods According to the level of β2-MG,666 newly diagnosed MM patients were divided into three groups as β2-MG〈3.5,3.5-〈5.5,≥5.5 mg/L.According to the level of serum creatinine,these patients were divided into two groups：serum creatinine 〈177 μmol/L as relatively normal group,serum creatinine ≥177 μmol/L as abnormal group.Results Among 666 patients,there were 416 male and 250 female,the median age was 58 （25-86） years old.Comparison of OS among β2-MG〈3.5,3.5-〈5.5,≥5.5 mg/L groups indicated that the median OS of the three groups were 85.75 （95% CI 70.99-100.50）,47.25 （95% CI 40.98-53.53） and 35.05 （95% CI 30.75-39.35） months,respectively （P〈0.01）.Comparison of OS between serum creatinine 〈177 and ≥177 mmol/L groups,the median OS of the two groups were 64.67 （95% CI 56.57-72.77） and 32.74 （95% CI 27.74-37.73） months,respectively （P〈 0.01）.In β2-MG≥5.5 mg/L,the median OS of relatively normal and abnormal groups were 37.25 （95% CI 31.45-43.06） and 32.55（95% CI 26.26-38.83） months,respectively （P=0.142）.Conclusions High level of β2-MG and renal function correlated with shorter survival of MM patients.Higher level of β2-MG with abnormal renal function can＇t change the prognostic value of β2-microglobulin on MM.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2015年第5期393-397,共5页
Chinese Journal of Hematology
基金
国家自然科学基金（81172255、81400175、81101794）
天津市科技支撑计划重大项目（12ZCDZSY17600）
关键词
多发性骨髓瘤
Β2微球蛋白
国际分期系统
肾功能
Multiple myeloma
beta 2-Microglobulin
International staging system
Renal function
