【摘要】 目的 探讨多发性骨髓瘤患者（MM）化疗前肾损伤的影响因素并初步建立MM患者肾损伤的预测模型。方法 回顾性分析2017年1月1日至2022年8月30日于南方医科大学附属广东省人民医院血液内科的初诊化疗前MM患者的临床资料，其中共纳入150例，以肌酐清除率为标准将其分为非肾损伤组（n=103）和肾损伤组（n=47）。通过单因素和多因素Logistic回归分析得出MM患者化疗前肾损伤的独立危险因素，并构建发生肾损伤的预测模型，评估预测模型的校准度和区分度。结果 多因素Logistic回归分析显示年龄、中性粒细胞计数、血清β₂微球蛋白（β₂-MG）、尿素氮是MM患者化疗前肾损伤的危险因素，而体重是其保护因素。构建模型：P（z）=1/(1+e^-z),z=-13.792+0.155×年龄+0.895×中性粒细胞计数+0.564×尿素氮+0.675×血清β₂-MG-0.192×体重，P（z）≥0.33时，诊断为肾损伤，灵敏度为95.7%,特异度为96.1%。结论 初步建立MM患者化疗前肾损伤的预测模型有较好的预测价值，有助于临床早期干预和选择对MM患者化疗前肾损伤较小的化疗方案。更多还原

【Abstract】 Objective To investigate the risk factors for renal impairment of patients with Multiple Myeloma（MM）before chemotherapy and construct a preliminary prediction model based on these factors.Methods From January 1,2017 to August 30,2022,the clinical data of MM patients who were newly diagnosed before chemotherapy in the Department of Hematology, Guangdong Provincial People′s Hospital, Southern Medical University were retrospectively analyzed.A total of 150 MM patients were collected.They were divided into two groups according to whether there was complicated with renal impairment（n=47） or not（n=103）.Univariate and multivariate Logistic regression analysis were used to identify risk factors for renal impairment in MM patients before chemotherapy and construct a predictive model, and to evaluate the calibration and discrimination.Results Multivariate analysis showed that age, weight, neutrophil count, serum β₂-microglobulin（β₂-MG）,urea nitrogen were risk factors for renal impairment in MM patients before chemotherapy, while weight was a protective factor.The prediction model was constructed by multivariate Logistic regression analysis as P（z）=1/(1+e^-z) and z=-13.792+0.155×age+0.895×neutrophil count+0.564×urea nitrogen+0.675×serum β₂-MG-0.192×weight.If P（z）≥0.33,the prediction pointed to renal impairment.The sensitivity was 95.7% and the specificity was 96.1%.Conclusion The preliminary prediction model for renal impairment in MM patients before chemotherapy has good predictive value, which is benefit to early intervene and select chemotherapy regimens with less renal toxicity for MM patients before chemotherapy.更多还原