本文選題：血清鐵蛋白 + 多發(fā)性骨髓瘤　； 參考：《南昌大學》2016年碩士論文

【摘要】：背景與目的:多發(fā)性骨髓瘤(Multiple myeloma,MM)是一種多發(fā)于中老年的惡性腫瘤,臨床癥狀、細胞遺傳學表現(xiàn)多種多樣,其預后因素眾多,單一因素不足以決定其預后,需多個因素聯(lián)合分析對患者進行分期和危險分層。因此,探索新的預后因素在MM疾病的診療中意義重大。血清鐵蛋白(Serum Ferritin,SF)作用廣泛,跟鐵貯存、炎癥及腫瘤有關(guān)。SF可作為血液腫瘤的一個不良預后因素,有助于腫瘤負荷和療效監(jiān)測。本文通過觀察初治MM患者SF水平,分析SF水平與MM患者臨床特征、療效的關(guān)系,探索SF在MM診斷、療效監(jiān)測中的重要意義。方法:收集南昌大學第一附屬醫(yī)院2009年1月到2015年12月期間住院的多發(fā)性骨髓瘤患者病例資料87例,所有患者均為初治病例。分析SF水平與初治MM患者各項臨床特征及預后的關(guān)系。應用SPSS 18.0軟件,計量資料統(tǒng)計描述:服從正態(tài)分布時采用平均數(shù)(`X±S),不服從正態(tài)分布時采用中位數(shù);兩樣本均數(shù)比較,若兩樣本均服從正態(tài)分布時采用t檢驗,否則采用非參數(shù)秩和檢驗;相關(guān)分析采用Spearman檢驗。相關(guān)分析以P0.01為差異具有統(tǒng)計學意義,其他以P0.05為差異具有統(tǒng)計學意義。結(jié)果:87例患者中男性有55例,女性有32例,平均年齡為58.32±10.73歲。骨痛和頭暈乏力為患者初診時最常見的癥狀,分別為39%、18.3%,大部分患者就診時為中度貧血,占43.7%。72.4%患者處于Durie-Salmon(DS)Ⅲ期,47.1%患者處于International Staging System(ISS)Ⅲ期,IgG型最常見,占46%。采用Spearman多元相關(guān)分析,顯示SF與血肌酐、血乳酸脫氫酶(Lactate Dehydrogenase,LDH)、C反映蛋白(C-Reactive Protein,C RP)、血β2微球蛋白(β2-microglobulin,β2-Mg)、分期、療效呈直線相關(guān)。SF較高組與較低組比較在年齡、性別、血紅蛋白、血小板、淋巴細胞絕對數(shù)、白蛋白、骨髓漿細胞比例分布上無明顯差異,在血鈣、血LDH、血肌酐、CRP、血β2-Mg、分型、分期、療效分布上具有差異。結(jié)論:1、多發(fā)性骨髓瘤中SF升高的原因可能與腫瘤相關(guān)的炎癥狀態(tài)有關(guān)。2、SF可反映多發(fā)性骨髓瘤腫瘤負荷,可用于多發(fā)性骨髓瘤療效監(jiān)測、預后評估。
[Abstract]:Background & objective: multiple myeloma (MM) is a kind of malignant tumor in middle and old age. Its clinical symptoms, cytogenetic manifestations and prognostic factors are various, and the single factor is not enough to determine its prognosis.Multiple factors are needed for staging and risk stratification.Therefore, exploring new prognostic factors is of great significance in the diagnosis and treatment of MM disease.Serum ferritin (Serum Ferritinus SF) has a wide range of effects. SF, which is related to iron storage, inflammation and tumor, can be used as a poor prognostic factor for blood tumors, which is helpful for monitoring tumor load and curative effect.By observing the level of SF in newly treated MM patients and analyzing the relationship between SF level and the clinical characteristics and curative effect of MM patients, the significance of SF in the diagnosis and monitoring of MM was explored.Methods: 87 patients with multiple myeloma were collected from January 2009 to December 2015 in the first affiliated Hospital of Nanchang University.To analyze the relationship between SF level and clinical features and prognosis of newly treated MM patients.Using SPSS 18.0 software, the statistical description of the measurement data: the average (`X 鹵S) when taking the normal distribution, the median when not using the normal distribution, the comparison of the mean of the two samples, if the two samples are taken from the normal distribution, the t test is used.Otherwise, nonparametric rank sum test was used, and Spearman test was used for correlation analysis.Correlation analysis with P0.01 as the difference was statistically significant, other P0.05 as the difference was statistically significant.Results there were 55 males and 32 females in the 87 cases. The average age was 58.32 鹵10.73 years.Bone pain and dizziness were the most common symptoms in the first visit, which were 39 and 18.3.The majority of the patients were moderate anemia, accounting for 43.7.72.4% of the patients were in Durie-Salmon DS) stage 鈪，

本文編號：1744655