本文選題：多發(fā)性骨髓瘤 + 臨床特征�。� 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討多發(fā)性骨髓瘤(Multiple myeloma,MM)患者的臨床特征及影響MM患者生存的相關(guān)預(yù)后因素。資料和方法:收集廣西醫(yī)科大學(xué)附屬腫瘤醫(yī)院2011年01月01日至2016年12月31日共收治164例初治的MM患者,并對(duì)這些患者的臨床特征、實(shí)驗(yàn)室指標(biāo)及治療方案進(jìn)行回顧性分析,同時(shí)對(duì)其中資料完整的84例患者使用Kaplan-Meier法進(jìn)行生存分析,單因素分析使用Log-rank檢驗(yàn),多因素分析使用COX比例風(fēng)險(xiǎn)回歸模型。結(jié)果:164例患者中位年齡58歲(25~89歲),男女比例1.6:1,D-S分期III期及ISS分期III期的患者比例分別為60.98%,57.46%;38例收集到完整免疫分型資料的MM患者以Ig G型為主,占55.2%,其次為輕鏈型,占21.1%。對(duì)84例具有完整隨訪資料的MM患者進(jìn)行生存分析,單因素分析發(fā)現(xiàn)血清肌酐水平升高的患者PFS差于肌酐水平正常的患者,差異具有統(tǒng)計(jì)學(xué)意義(P=0.023)。血清白蛋白降低的患者PFS差于血清白蛋白正常的患者,差異具有統(tǒng)計(jì)學(xué)意義(P=0.000)。多因素分析發(fā)現(xiàn)血清白蛋白(HR=0.358,95%CI:0.187-0.685,P=0.002)是影響MM患者PFS的獨(dú)立相關(guān)因素;血清肌酐(HR=2.055,95%CI:1.055-4.005,P=0.034)及白蛋白(HR=0.304,95%CI:0.136-0.680,P=0.004)均為影響MM患者OS的獨(dú)立相關(guān)因素。結(jié)論:(1)本院164例多發(fā)性骨髓瘤患者中位發(fā)病年齡偏低,男性多見于女性;超過半數(shù)的患者初診時(shí)分期偏晚;免疫分型以Ig G型為主。(2)血清白蛋白及血清肌酐可作為MM患者總生存期的獨(dú)立預(yù)測(cè)因素。
[Abstract]:Objective: To investigate the clinical characteristics of Multiple myeloma (MM) patients and the related prognostic factors that affect the survival of MM patients. Data and methods: a total of 164 first treated MM patients were collected from 01 months of 2011 to 31 of December 2016 in the Affiliated Cancer Hospital of Guangxi Medical University. The treatment scheme was analyzed retrospectively, and 84 patients with complete data were analyzed by Kaplan-Meier method, single factor analysis using Log-rank test, and multifactor analysis using COX proportional hazard regression model. Results: 164 patients were 58 years of age (25~89 years), 1.6:1, D-S stage III and ISS stage III stage. The proportion of patients was 60.98%, 57.46%, 38 cases of MM patients with complete immunophenotyping data were mainly Ig G, 55.2%, followed by light chain type, and 84 cases of MM patients with complete follow-up data were analyzed by 21.1%.. The single factor analysis found that the patients with elevated serum creatinine level were worse than those with normal creatinine level. The difference was statistically significant (P=0.023). The PFS of serum albumin decreased in patients with normal serum albumin, the difference was statistically significant (P=0.000). The multifactor analysis found that serum albumin (HR=0.358,95%CI:0.187-0.685, P=0.002) was the independent dependent factor affecting PFS in MM patients; serum creatinine (HR=2.055,95%CI:1.055-4.005, P=0.) 034) and albumin (HR=0.304,95%CI:0.136-0.680, P=0.004) are the independent factors affecting OS in MM patients. Conclusion: (1) the median age of 164 cases of multiple myeloma in 164 patients in our hospital is lower, and more than half of the patients are late at first diagnosis; the immunization type is mainly Ig G. (2) serum albumin and serum creatinine can be found. As an independent predictor of the total survival of MM patients.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R733.3

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