血脂水平对多发性骨髓瘤患者临床特点及预后的价值研究

Study on the Value of Blood Lipid Level in the Clinical Characteristics and Prognosis of Patients with Multiple Myeloma

摘要: 目的：探讨多发性骨髓瘤(Multiple Myeloma, MM)的脂质代谢特点以及血脂水平在MM患者临床特点及预后中的价值。方法：收集2017年7月至2023年2月青岛大学附属医院收治的初诊MM患者，分别分析MM患者血脂水平与临床分期、免疫球蛋白分型、治疗效果以及总生存期之间的相关性。结果：在TC、LDL、HDL、Apo-A1、Apo-B水平上，ISS分期I期患者高于II期和III期患者，差异有统计学意义(P < 0.05)；轻链型患者的TC、LDL、Apo-A1、Apo-B水平高于IgG型和IgA型患者，差异有统计学意义(P < 0.05)，IgG型患者的TC、LDL、Apo-B水平高于IgA型患者，差异有统计学意义(P < 0.05)；经过四周期治疗后，缓解组患者的血脂相关指标水平均较治疗前升高，差异有统计学意义(P < 0.05)；TC、LDL、Apo-A1、Apo-B低水平组患者总生存期更短，预后更差(P < 0.05)。结论：血脂水平在MM患者临床特点及预后中具有重要意义。

Abstract: Objective: To investigate the characteristics of lipid metabolism in multiple myeloma and the value of blood lipid levels in the clinical characteristics and prognosis of patients with multiple myeloma. Methods: We collected the patients with newly diagnosed multiple myeloma admitted to the Affiliated Hospital of Qingdao University from July 2017 to February 2023. The correlation between blood lipid levels and clinical stage, immunoglobulin typing, treatment effect and overall survival of patients with multiple myeloma was analyzed. Results: The levels of TC, LDL, HDL, Apo-A1 and Apo-B in patients with ISS stage I were higher than those in patients with ISS stage II and III, and the difference was statistically significant (P < 0.05). The levels of TC, LDL, Apo-A1 and Apo-B in patients with light chain type were higher than those in patients with IgG type and IgA type, and the difference was statistically significant (P < 0.05). The levels of TC, LDL and Apo-B in patients with IgG type were higher than those in patients with IgA type, and the difference was statistically significant (P < 0.05). After four cycles of treatment, the levels of blood lipid related indicators in the remission group were higher than those before treatment, and the difference was statistically significant (P < 0.05). The patients with low levels of TC, LDL, Apo-A1, and Apo-B had shorter overall survival and worse prognosis (P < 0.05). Conclusion: Blood lipid levels are of great significance in the clinical characteristics and prognosis of patients with multiple myeloma.