多发性骨髓瘤患者血清胆固醇水平的临床意义

 目的　探讨多发性骨髓瘤（MM）患者血清胆固醇水平变化及其与分型、分期的关系。方法　回顾分析65例MM患者诊断时血脂水平，包括总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白A1（Apo-A1）和载脂蛋白B（Apo-B），探讨血脂参数与MM患者免疫球蛋白类型和临床分期关系。以健康体检者30例作为对照组。结果　65例MM患者中IgG型35例（53.85 %），Ⅲ期41例（63.1 %），MM患者血清TC、HDL-C、 LDL-C、Apo-A1和Apo-B明显低于对照组 （P＜0.05），两组TG差异无统计学意义（P＞0.05）；除1例IgD型外，其余64例患者中，IgG和IgA型患者血清TC、HDL-C、LDL-C、Apo-A1和Apo-B均显著低于轻链型（P＜0.05），TG水平在不同Ig类型患者间无差别；Ⅲ期患者血清TC、HDL-C、LDL-C和Apo-A1均显著低于Ⅰ期患者和对照组（P均＜0.05），且Ⅱ期患者血清LDL-C 也显著低于Ⅰ期患者（P＜0.05）。结论　MM患者存在低胆固醇血症，且血清胆固醇水平与疾病分期有关。

Clinical significance of serum cholesterol levels in multiple myeloma

Objective To investigate the relationship between serum cholesterol levels and immunoglobin types and clinical stages in the patients with multiple myeloma (MM). Methods We retrospectively analyzed the blood lipid levels in 65 patients with MM at diagnosis, including total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein Al (apo-Al) and apolipoprotein B (apo-B), and explored relationship between lipid parameters and immunoglobulin types or clinical stages in patients with MM. Thirty healthy persons were served as controls. Results Of the 65 MM patients, 53.85% were IgG type, 63.1 % were at stage Ⅲ. The levels of TC, HDL-C, LDL-C, apo Al and apo B in the patients with MM were significantly lower than that in the controls (P <0.05), and TG in MM patients was no difference with that in the controls (P >0.05). Except one case of IgD type, the levels of TC, HDL-C, LDL-C, apo Al and apo B in Ig G and Ig A types of patients were significantly lower than that in the light chain type among other 64 cases (P <0.05), and TG levels in different immunoglobulin types was found no statistical differences. The levels of TC, HDL-C, LDL-C and apo A1 in the patients with stage Ⅲ were lower than that of stage I and controls (P <0.05), furthermore, the level of LDL in stage Ⅱwas lower than that in stage Ⅰ. Conclusion Hypocholesterolemia are seen in the patients with MM and serum cholesterol levels are related to MM staging.