血胆固醇水平对多发性骨髓瘤患者生存状况的影响
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摘要
目的探索血胆固醇水平对多发性骨髓瘤患者生存状况的影响。方法选取2014-06至2017-09医院接受治疗的136例多发性骨髓瘤患者为观察组,另选取同期82例接受体检的健康者为对照组,收集患者一般资料并进行回顾性分析。结果观察组的血清总胆固醇[(2. 67±1. 12) mmol/L]、低密度脂蛋白[(1. 62±0. 98) mmol/L]、载脂蛋白B[(0. 45±0. 28) mmol/L]及高密度脂蛋白水平[(0. 81±0. 28) mmol/L],与对照组相比,差异有统计学意义(P <0. 05)。Ⅲ期患者生存率显著低于Ⅰ期和Ⅱ期,差异有统计学意义(P <0. 05)。Ig A型多发性骨髓瘤患者的低密度脂蛋白水平[(1. 38±0. 56) mmol/L]最低,轻链型多发性骨髓瘤患者的低密度脂蛋白水平[(2. 25±0. 43) mmol/L]最高,差异有统计学意义(P <0. 05)。结论多发性骨髓瘤的疾病发展状况和生存状况与血胆固醇水平有密切关系,血胆固醇水平过低导致患者病情恶化,产生较高耐药性,从而降低生存率及生存质量。
Objective To explore the effects of blood cholesterol levels on the survival of patients with multiple myeloma.Methods One hundred and thirty-six patients with multiple myeloma who were treated in the hospital between June 2014 and September 2017 were selected as the observation group,while another eighty-two healthy physical examinees were selected as the control group. Relevant data was collected and retrospectively analyzed. Results Serum levels of total cholesterol [(2. 67 ± 1. 12) mmol/L],low-density lipoprotein [(1. 62 ± 0. 98) mmol/L],apolipoprotein B [(0. 45 ± 0. 28) mmol/L] and high-density lipoprotein [(0. 81± 0. 28) mmol/L]were significantly lower in the observation group than in the control group(P < 0. 05). The survival rate of stage Ⅲpatients was significantly lower than that of stage Ⅰ and stage Ⅱ patients(P < 0. 05). Low-density lipoprotein levels [(1. 38 ± 0. 56)mmol/L]were the lowest in patients with Ig A multiple myeloma,but [(2. 25 ± 0. 43) mmol/L]were the highest in patients with lightchain multiple myeloma(P < 0. 05). Conclusions The development and survival of multiple myeloma are closely related to blood cholesterol levels that depend on the intake of low-density lipoprotein. Low blood cholesterol levels can lead to the deterioration of a patient's condition and drug resistance,which negatively affects patients' survival and quality of life.
Objective To explore the effects of blood cholesterol levels on the survival of patients with multiple myeloma.Methods One hundred and thirty-six patients with multiple myeloma who were treated in the hospital between June 2014 and September 2017 were selected as the observation group,while another eighty-two healthy physical examinees were selected as the control group. Relevant data was collected and retrospectively analyzed. Results Serum levels of total cholesterol [(2. 67 ± 1. 12) mmol/L],low-density lipoprotein [(1. 62 ± 0. 98) mmol/L],apolipoprotein B [(0. 45 ± 0. 28) mmol/L] and high-density lipoprotein [(0. 81± 0. 28) mmol/L]were significantly lower in the observation group than in the control group(P < 0. 05). The survival rate of stage Ⅲpatients was significantly lower than that of stage Ⅰ and stage Ⅱ patients(P < 0. 05). Low-density lipoprotein levels [(1. 38 ± 0. 56)mmol/L]were the lowest in patients with Ig A multiple myeloma,but [(2. 25 ± 0. 43) mmol/L]were the highest in patients with lightchain multiple myeloma(P < 0. 05). Conclusions The development and survival of multiple myeloma are closely related to blood cholesterol levels that depend on the intake of low-density lipoprotein. Low blood cholesterol levels can lead to the deterioration of a patient's condition and drug resistance,which negatively affects patients' survival and quality of life.
引文
[1]马丛丛,刘彦琴.多发性骨髓瘤患者血脂水平的变化及其临床意义[J].实用临床医药杂志,2014,23(7):113-115.
[2]古流芳,崔晓光,何爱丽,等.多发性骨髓瘤低胆固醇血症与预后相关性分析及机制[J].兰州大学学报(医学版),2018,44(1):48-52.
[3]克依木江·吾卜力卡司木,吐尔逊江·司拉木,阿地拉·苏力坦,等.多发性骨髓瘤患者血脂与血清α1-酸性糖蛋白检测的意义[J].现代检验医学杂志,2015,30(5):168-169.
[4]何伶俐,柯勇.多发性骨髓瘤患者HBs Ag检测及HBV感染的风险研究[J].中国实验血液学杂志,2017,25(6):1718-1721.
[5]卢静,杜鹃,傅卫军,等.修订的国际分期系统(R-ISS)在初诊多发性骨髓瘤患者预后判断中的意义[J].中华血液学杂志,2017,38(6):475-479.
[6]Hutchinson A T,Malik A,Berkahn M B,et al.Formation of assemblies on cell membranes by secreted proteins:molecular studies of free light chain aggregates found on the surface of myeloma cells[J].Biochemical J,2013,454(3):479-489.
[7]王双玲,刘峰,陈江声,等.多发性骨髓瘤患者肺部感染的临床特点及相关因素分析[J].中国感染与化疗杂志,2017,17(3):253-255.
[8]金晓娜,周宝珍,张党锋,等.多发性骨髓瘤患者VEGF、IL-17、β2-MG、IL-35表达水平及临床意义[J].中国实验血液学杂志,2018,26(1):192-196.
[9]Yang C,He X,Chen J,et al.Fe3O4nanoparticle loaded paclitaxel induce multiple myeloma apoptosis by cell cycle arrest and increase cleavage of caspases in vitro[J].J Nanopart Res,2013,15(8):18401-18413.
[10]高鹏,肖中平,付堃,等.血小板平均体积测定在多发性骨髓瘤中的临床意义[J].中国实验血液学杂志,2017,25(3):827-831.
[11]Dutoit J C,Vanderkerken M A,Verstraete K L,et al.Value of whole body MRI and dynamic contrast enhanced MRI in the diagnosis,follow-up and evaluation of disease activity and extent in multiple myeloma[J].Eur J Radiol,2013,82(9):1444-1452.
[12]王蕾,李艳.多发性骨髓瘤侧群细胞的研究进展[J].中国实验血液学杂志,2017,25(4):1250-1254.
[13]Tarek B,Daniel C,Elodie F,et al.Plasma cells release membrane microparticles in a mouse model of multiple myeloma[J].Int J Microscopy,2013,54:75-81.
[14]王路,张翼鷟.伴髓外病变的多发性骨髓瘤研究进展[J].中国实验血液学杂志,2016,24(3):945-948.
[15]Tageja N,Manasanch E E,Korde N,et al.Smoldering multiple myeloma:present position and potential promises[J].Eur J Haematol,2014,92(1):1-12.
[2]古流芳,崔晓光,何爱丽,等.多发性骨髓瘤低胆固醇血症与预后相关性分析及机制[J].兰州大学学报(医学版),2018,44(1):48-52.
[3]克依木江·吾卜力卡司木,吐尔逊江·司拉木,阿地拉·苏力坦,等.多发性骨髓瘤患者血脂与血清α1-酸性糖蛋白检测的意义[J].现代检验医学杂志,2015,30(5):168-169.
[4]何伶俐,柯勇.多发性骨髓瘤患者HBs Ag检测及HBV感染的风险研究[J].中国实验血液学杂志,2017,25(6):1718-1721.
[5]卢静,杜鹃,傅卫军,等.修订的国际分期系统(R-ISS)在初诊多发性骨髓瘤患者预后判断中的意义[J].中华血液学杂志,2017,38(6):475-479.
[6]Hutchinson A T,Malik A,Berkahn M B,et al.Formation of assemblies on cell membranes by secreted proteins:molecular studies of free light chain aggregates found on the surface of myeloma cells[J].Biochemical J,2013,454(3):479-489.
[7]王双玲,刘峰,陈江声,等.多发性骨髓瘤患者肺部感染的临床特点及相关因素分析[J].中国感染与化疗杂志,2017,17(3):253-255.
[8]金晓娜,周宝珍,张党锋,等.多发性骨髓瘤患者VEGF、IL-17、β2-MG、IL-35表达水平及临床意义[J].中国实验血液学杂志,2018,26(1):192-196.
[9]Yang C,He X,Chen J,et al.Fe3O4nanoparticle loaded paclitaxel induce multiple myeloma apoptosis by cell cycle arrest and increase cleavage of caspases in vitro[J].J Nanopart Res,2013,15(8):18401-18413.
[10]高鹏,肖中平,付堃,等.血小板平均体积测定在多发性骨髓瘤中的临床意义[J].中国实验血液学杂志,2017,25(3):827-831.
[11]Dutoit J C,Vanderkerken M A,Verstraete K L,et al.Value of whole body MRI and dynamic contrast enhanced MRI in the diagnosis,follow-up and evaluation of disease activity and extent in multiple myeloma[J].Eur J Radiol,2013,82(9):1444-1452.
[12]王蕾,李艳.多发性骨髓瘤侧群细胞的研究进展[J].中国实验血液学杂志,2017,25(4):1250-1254.
[13]Tarek B,Daniel C,Elodie F,et al.Plasma cells release membrane microparticles in a mouse model of multiple myeloma[J].Int J Microscopy,2013,54:75-81.
[14]王路,张翼鷟.伴髓外病变的多发性骨髓瘤研究进展[J].中国实验血液学杂志,2016,24(3):945-948.
[15]Tageja N,Manasanch E E,Korde N,et al.Smoldering multiple myeloma:present position and potential promises[J].Eur J Haematol,2014,92(1):1-12.