多发性骨髓瘤不同分期C-反应蛋白、血红蛋白、红细胞沉降率检测的临床意义

 【摘要】　目的 探讨多发性骨髓瘤（MM）中C-反应蛋白（CRP）、血红蛋白（Hb）、红细胞沉降率（ESR）3项指标的变化及其临床意义。方法 选取新诊断的30例MM患者，记录首次入院的实验室检查指标及临床指标，行国际分期体系（ISS）分期。以同期住院的30例年龄、性别、Hb相仿的巨幼细胞贫血（MA）患者作为对照组。对比不同ISS分期MM中CRP、Hb、ESR的差异，并分析3个指标与肿瘤细胞比例、 β2-微球蛋白（β2-MG）的相关性。结果 MM组Ⅲ期患者CRP、Hb、ESR分别为（24.17±9.87）mg／L、（71.72±13.27）g／L、（105.94±27.73）mm／h，Ⅰ、Ⅱ期分别为（8.54±1.97）mg／L、（91.00±9.92） g／L、（67.00±15.56） mm／h和（14.89±5.51）mg／L、（91.29±8.32） g/L、（73.57±20.53） mm／h，Ⅲ期与Ⅰ、Ⅱ期比较，差异均有统计学意义（均P＜0.05）。MM组CRP、ESR分别为（19.40±10.17） mg／L、（91.90±29.70）mm／h，MA组分别为（7.52±1.57）mg／L、（20.20±8.04）mm／h，差异均有统计学意义（均P＜0.05）。MM患者CRP、Hb、ESR与肿瘤细胞比例、β2-MG有一定相关性（均P＜0.05）。结论　MM病情发展与CRP、Hb、ESR有密切关系，CRP、Hb相对ESR对疾病反应敏感，联合检测3项指标对于观察患者病情进展有明显的临床意义。

Clinical significance of determination of C-reactive protein, hemoglobin, erythrocyte sedimentation rate in the different stages of patients with multiple myeloma

Objective To analyze the changes and clinical sisnificance of C-reactive protein （CRP）, hemoglobin （Hb） and erythrocyte sedimentation rate （ESR） in different disease stage of multiple myeloma according the international staging system. Method Thirty untreated MM patients with complete clinical records were included in the study. The muhiple myeloma patients were classified into three groups according to international staging system （ISS）. Thirty megaloblastic anemia patients of similar age .sex,hemoglobin level as the observation group. Resulets The levels of CRP （24.17±9.87 mg/L）,Hb （71.72±13.27 g/L） and ESR （105.94±27.73 ram/h） of stage Ⅲ patients were statistically different with stage I （ CRP 8.54±1.97 mg/L; Hb91.00±9.92g/L; ESR 73.57±20.53mm/h）、 Ⅱ patients （CRP 14.89±5.51 rag/L; Hb 91.29±8.32g/L; ESR 67.00± 15.56 turn/h） separately （P〈0.05）. The levels of CRP （19.40±10.17 rag/L） and ESR （91.90±29.70 mm/h） in the MM patients were significantly higher than that in the observation group I （ CRP 7.52±1.57mg/L; ESR 20.20± 8.04mm/h） （P〈0.05 respectively）. CRP and ESR level in MM patients positively eorrelated with myeloma cell proportion and 132-mieroglobulin level （P〈0.05）, while Hb level negatively correlated with myeloma cell proportion and β2-microglobulin level （P〈0.05）, Conclusion The levels of C-reactive protein,hemoglobin and erythroeyte sedimentation rate are closely associated with the development of multiple myeloma. C-reactive protein and hemoglobin are relatively sensitive response to disease than erythrocyte sedimentation rate. There is a clear clinical implication in detecting the patient＇ s condition for progress and the prognosis.