【摘要】 目的探讨初诊多发性骨髓瘤患者凝血指标的变化及意义。方法回顾性分析2008年10月—2012年10月中国医科大学附属第一医院血液科收治的初诊多发性骨髓瘤患者96例,检测凝血酶原时间(PT)、部分活化的凝血活酶时间(APTT)、纤维蛋白原(Fg)水平。并分析凝血指标的变化与一般资料、疾病分期、肝功能指标、M蛋白水平的关系。结果 96例患者中,单纯PT延长的患者25例,单纯APTT延长的患者5例,PT及APTT同时延长的患者11例。96例患者中PT延长组36例,非PT延长组60例,两组患者性别、年龄及丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(γ-GT)、总胆红素(TBIL)水平比较,差异均无统计学意义(P>0.05);两组DS分期、ISS分期及Fg水平比较,差异均有统计学意义(P<0.05)。PT延长组IgA型和IgG型患者M蛋白水平较非PT延长组升高(P<0.05)。IgA型和IgG型患者PT与M蛋白水平均呈正相关(r值分别为0.619和0.664,P<0.05)。结论在初诊的多发性骨髓瘤患者中,PT延长多见于DS分期和ISS分期Ⅲ期患者,且在IgA及IgG两型患者中合并M蛋白水平明显升高,并与PT呈正相关。更多还原

【Abstract】 Objective To discuss the changes and clinical significance of coagulation index in patients of newly diagnosed multiple myeloma.Methods The clinical data of 96 patients with newly diagnosed multiple myeloma who were treated in Department of Hematology,the First Hospital of China Medical University,from October 2008 to October 2012,was analyzed retrospectively,APTT,PT and Fg level were detected.The relationship between the the changes of coagulation index and the general information,stage of disease,liver function index,the level of M protein was analyzed.Results Among 96 patients,25 patients had prolonged PT alone,5 had prolonged APTT alone,11 had both prolonged PT and APTT.Among 96 patients,36 were included in prolonged PT group,60 were included in non- prolonged PT group,there was no significant difference in gender,age,ALT level,γ- GT level and TBIL level between two groups(P > 0.05).There were significant differences in stage of DS,stage of ISS and level of Fg between two groups(P < 0.05).M protein levels of IgA type patients and IgG type patients in prolonged PT group were significantly higher than those in non- prolonged PT group,the differences were statistically significant(P < 0.05).The level of M protein was positively correlated with PT among both IgA type patients and IgG type patients(r = 0.619 and 0.664 respectively,P < 0.05).Conclusion Prolonged PT commonly exists in the newly diagnosed multiple myeoloma with Ⅲ stage of DS and ISS,prolonged PT and high level of M protein commonly exist in IgA type patients and IgG type patients.The level of M protein in these two types of patients with prolonged PT was positively correlated with PT.更多还原