骨代谢标志物与多发性骨髓瘤患者临床特征的相关性及其在疗效判断中的意义
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河北省沧州市科学技术研究与发展指导计划项目(213106073);


Correlation between bone metabolism markers and clinical features of pa-tients with multiple myeloma and their significance in efficacy judgment
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    摘要:

    目的:研究骨代谢标志物与多发性骨髓瘤(MM)患者临床特征的相关性及其在疗效判断中的意义。方法:纳入112例MM患者作为研究对象,收集患者临床特征相关资料、治疗前后骨代谢标志物水平,分析骨代谢标志物与MM患者临床特征的相关性;比较不同疗效患者治疗前后骨代谢标志物变化;绘制受试者工作特征(ROC)曲线,分析入院时、治疗后血清P1NP、β-CTX、OCN-MID对MM患者疗效的预测价值。结果:IgD型患者入院时β-CTX水平高于IgA型、IgG型、轻链型,差异均有统计学意义(P<0.05)。不同DS分期与ISS分期患者入院时β-CTX水平比较:Ⅲ期>Ⅱ期>Ⅰ期;P1NP、OCN-MID水平比较:Ⅲ期<Ⅱ期<Ⅰ期,差异均有统计学意义(P<0.05)。患者治疗4个疗程后有效率为71.43%;难治无效率为28.57%。有效组入院时β-CTX低于难治无效组,P1NP高于难治无效组,差异均有统计学意义(P<0.05)。有效组治疗4个疗程后P1NP、OCN-MID水平均高于入院时,且高于难治无效组;β-CTX水平低于入院时,且低于难治无效组;差异均有统计学意义(P<0.05)。入院时β-CTX>0.79μg/L,治疗后β-CTX>0.71μg/L预测MM患者疗效不佳的AUC(95%CI)分别为0.691(0.569~0.814)、0.756(0.635~0.878),有较高的预测价值。入院时、治疗后P1NP、OCN-MID的AUC均<0.5,无预测价值。结论:IgD型与高DS分期、ISS分期患者更易发生骨质疏松症和溶骨性损害。高β-CTX水平患者对治疗的反应性较差,可作为预测MM患者疗效、分期的辅助指标。

    Abstract:

    Objective:To study the correlation between bone metabolism markers and clinical features of patients with multiple myeloma(MM)and their significance in efficacy judgment.Methods:A total of 112 MM patients were included as the study subjects,and the relevant data of clinical characteristics and the level of bone metabolic markers before and after treatment were collected,and the correlation between bone metabolic markers and clinical characteristics of MM patients was analyzed.The changes of bone metabo-lism markers in patients with different therapeutic effects were compared before and after treatment.Receiver operating characteristic curve(ROC)was drawn to evaluate the efficacy of serum P1NP,β-CTX and OCN-MID in MM patients at admission,1,2 and 4 treat-ment courses.Results:The level of β-CTX in IgD patients was higher than IgA,IgG and light chain patients,with statistically signifi-cant differences(P<0.05).The level of β-CTX in DS stage and ISS stage Ⅲ patients was higher than that in I stage and Ⅱ stage,stage Ⅱ>stage I,the levels of P1NP and OCN-MID in stage III were lower than those in stage I and stage II.StageⅡ

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于巧亚;褚娜利;闫石;尹盼盼;乔建启;范泽文;胡海涛;.骨代谢标志物与多发性骨髓瘤患者临床特征的相关性及其在疗效判断中的意义[J].川北医学院学报,2025,40(5):638-641 646.

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  • 在线发布日期: 2025-07-09
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