多发性骨髓瘤危险因素及早期诊断指标的研究

目的回顾分析51例初诊多发性骨髓瘤（multiple myeloma,MM）患者实验室检测结果,筛选MM危险因素,探索早期诊断指标。方法比较MM组与疾病对照组患者血常规、血清白蛋白（Alb）、肌酐（Cr）、乳酸脱氢酶（LDH）、血钙、血清β2-微球蛋白（β2-MG）、C-反应蛋白（CRP）测定值。对有显著差异的指标应用二分类Logistic回归,分析MM危险因素的相对危险度（odd ratio,OR）。应用多因素回归Stepwise法将有统计学意义的MM危险因素分别与MM患者免疫球蛋白测定值、骨髓浆细胞百分数进行相关分析。结果 MM患者Hb、PLT、Alb、Cr、血清β2-MG与疾病对照组患者相比差异具有统计学意义（P〈0.05）。将这5项指标进行多因素Logistic回归,显示Hb、血清β2-MG是对MM具有统计学意义的影响因素,OR分别为0.967,1.234。对这2项指标进一步分层,分别进行单因素Logistic回归,显示随着Hb减低,OR值由4.329升至17.588。同样随着β2-MG水平升高,OR值相应升高分别为5.143、12.800、21.333。多因素相关分析显示：MM患者Hb、血清β2-MG水平分别与免疫球蛋白定量、骨髓浆细胞百分数显著相关（P〈0.05）。结论患者贫血程度、血清β2-MG为罹患MM危险因素,并且这2项指标对MM临床早期发现、早期诊断具有重要提示作用。

Analysis of risk factors and early diagnosis to multiple myeloma

Objective Retrospected the laboratory tests results of newly diagnosed multiple myeloma,screening risk factors and looking for marks o（ early diagnosis to multiple myeloma. Methods The levels of complete blood count,ser- um albumin, ereatinine, lactate dehydrogenase,calcium, β2- mieroglobulin and C reactive protein for patients of multiple myeloma were collected and compared with the control group. The tests of statistically significant variables were evalua ted in odd model that Logistic regression analysis was used to predict the odd ratio （OR） values. And also the results of statistically significant variables were evaluated in muhivariaiLe model in which Stepwise regression analysis with the im- munological tests and the bone marrow examination. Results The hemoglobin, platelet, serum albumin,creatinine, and serum β2-microglobulin of the multiple myeloma patients had a significant differences in comparison with the control group patients（P〈0.05）. And the hemoglobin, serum β2-microglobulin were statistically significant factors for multiple myeloma by Logistic regression muhivariate analysis that the OR values were 0. 967,1. 234 respectively. Hemoglobin and 132 ruicroglobulin were further analyzed by Logistic regression univariate analysis respectively. The results showed that following the hemoglobin decreased, OR values increased from 4. 329 to 17. 588. And β2-microglobulin increased were high risk of suffering from MM ,which OR values were 5. 143.12. 800.21. 333 respectively. And also the hemoglo- bin and serum β2-mieroglobulin significantly correlated with the value of immunoglobin and the percent of plasma cells in bone marrow respectively （P〈0.05）. Conclusion Anemia and serum β2-microglobulin are high risk factors of multi ple myeloma. They could be great significant marks to early diagnosis of multiple myeloma.