【摘要】 目的:探讨血小板平均体积(MPV)在多发性骨髓瘤患者中的临床意义。方法:以本院2008年3月至2015年3月收治的198例多发性骨髓瘤(MM)患者为研究对象,收集的临床资料包括患者治疗前的Ig分型、血红蛋白、血小板数目、肌酐、钙离子、白蛋白、β2微球蛋白、乳酸脱氢酶、骨髓浆细胞、MPV、合并症(如糖尿病、VTE病史和动脉事件如冠状动脉疾病和脑血管疾病等)和并发症(如血栓形成)。将所有患者分为低MPV组(≤8.50 fl)和高MPV组(>8.50 fl),比较两组一般资料,生化指标和预后情况。结果:ROC曲线分析MPV的最佳阈值显示,当MPV为8.50fl时对应的最高灵敏度和特异性分别为55.56%和80.00%,AUC为0.656(95%CI:0.515-0.797)。MM患者IgA分型、肌酐水平和IgH重排与MPV相关。低MPV患者IgA分型和IgH重排比例均高于高MPV患者,而肌酐水平>176.8μmol/L患者的比例低于高MPV患者(P<0.05)。两组患者年龄、性别、ECOG PS、合并症、ISS分期、血红蛋白、血小板数目、钙离子、白蛋白、β2微球蛋白、乳酸脱氢酶、骨髓浆细胞比例差异均无统计学意义。低MPV患者OS较高MPV患者短(P=0.039)。单因素分析显示,MPV、BM浆细胞比例和年龄>60岁与OS相关。多因素分析显示,低MPV和BM浆细胞比例与较短的OS相关(P<0.05)。结论:低MPV与多发性骨髓瘤患者预后不良存在相关性,MPV可能是多发性骨髓瘤患者病情和预后评估的重要指标更多还原

【Abstract】 Objective: To investigate the clinical significance of mean platelet volume( MPV) in patients with multiple myeloma( MM). Methods: The clinical data of 198 patients with MM admitted in our hospital from March 2008 to March2015 were collected and analyzed. The clinical data included the Ig type,hemoglobin level,platelet count,creatinine,calciumion albumin,β2-MG,LDH,plasmocytes in bone marrow,MPV,complications such as diabetes,a history of venous thromboembolism( VTE) and arterial events such as coronary artery disease,cerebrovascular disease,thrombosis and blood clotting. All patients were divided into low MPV group( ≤8. 50 fl) and high MPV group( > 8. 50 fl). The biochemical parameters and prognosis of the 2 groups were compared. Results: When MPV was 8. 50 fl,the higest sensitivety and specificity were 55. 56% and 80. 00% respectively. The area under curve( AUC) was 0. 656( 95% CI: 0.515-0. 797),the IgA type,creatinine level and IgH rearrangement in MM patients were related with MPV. The ratio of IgA and IgH rearrangements in patients with low MPV was higher than that in patients with high MPV,and the ratio of patients with creatinine > 176. 8 μmol/L was lower than that of patients with high MPV( P < 0. 05). The age,sex,ECOG PS,complications,ISS stage,hemoglobin level,platelet count,calcium ion,albumin,β2 microglobulin,lactate dehydrogenase and bone marrow plasma cell ratio were not statistically significantly different between the 2 groups. Patients with low MPV had a shorter OS( P = 0. 039) than those with higher MPV. Univariate analysis showed that MPV,BM plasma cell ratio and age > 60 years correleted with OS. Multivariate analysis showed that the low MPV and BM plasma cell ratio were correlated with shorter OS( P < 0. 05). Conclusion: The low MPV is correlated with poor prognosis in patients with MM and may serve as an important indicator for disease progression and prognosis of patients with MM.更多还原