血清骨特异性碱性磷酸酶、同型半胱氨酸、护骨素变化对多发性骨髓瘤患者的临床应用价值

目的探讨血清骨特异性碱性磷酸酶(BALP)、同型半胱氨酸(Hcy)、护骨素(OPG)水平变化对多发性骨髓瘤患者的临床应用价值。方法选取2015年1月至2018年12月我科就诊的多发性骨髓瘤患者106例(实验组),健康对照组58例(对照组),比较两组受试者血清BALP、Hcy、OPG水平差异,观察血清BALP、Hcy、OPG在不同分期多发性骨髓瘤患者中的变化;Pearson分析血清BALP、Hcy、OPG变化与多发性骨髓瘤的相关性,ROC曲线分析血清BALP、Hcy、OPG对多发性骨髓瘤患者预后的预测价值。结果实验组血清Hcy水平高于对照组(P<0.05),实验组血清BALP、OPG水平低于对照组(P<0.05)。实验组治疗后不同预后患者的血清BALP、Hcy、OPG水平相比,差异具有统计学意义(P<0.05)。多发性骨髓瘤患者血清Hcy水平分别与血清β2-MG、LDH水平呈正相关(P<0.05),血清BALP、OPG水平与血清β2-MG、LDH水平呈负相关(P<0.05)。ROC曲线结果示:血清BALP、Hcy、OPG联合检测的曲线下面积为0.889,灵敏度和特异性分别为0.892和0.857。结论血清BALP、Hcy、OPG变化对多发性骨髓瘤病情发生发展具有重要意义;血清BALP、Hcy、OPG对多发性骨髓瘤患者的预后具有预测价值。

The Clinical Values of Serum Bone-specific Alkaline Phosphatase,Homocysteine and Osteoprotegerin in Patients with Multiple Myeloma

Objective To investigate the clinical values of serum bone-specific alkaline phosphatase(BALP),homocysteine(Hcy)and osteoprotegerin(OPG)levels in patients with multiple myeloma.Methods A total of 106 patients with multiple myeloma(the experimental group)and 58 healthy controls(the control group)were enrolled in our department from January,2015 to December,2018.The differences of serum BALP,Hcy and OPG levels between the two groups were compared.The changes of serum BALP,Hcy and OPG in patients with multiple myeloma of different stages were also observed.Pearson method was applied to analyze the correlation between serum BALP,Hcy,OPG and multiple myeloma.The ROC curve was used to evaluate the predictive values of these three markers in the prognosis of patients with multiple myeloma.Results The serum Hcy level in the experimental group was higher than that in the control group(P<0.05).The serum BALP and OPG levels in the experimental group were lower than those in the control group(P<0.05).The serum BALP,Hcy and OPG levels in the experimental group were significantly different after treatment(P<0.05).Serum Hcy level in patients with multiple myeloma was positively correlated with serumβ2-MG and LDH levels(P<0.05).Serum BALP and OPG levels were negatively correlated with serumβ2-MG and LDH levels(P<0.05).The results of ROC curve showed that the area under the curve of serum BALP,Hcy and OPG was 0.889 and the sensitivity and specificity were 0.892 and 0.857,respectively.Conclusion The changes of serum BALP,Hcy and OPG are important for the development of multiple myeloma.Serum BALP,Hcy and OPG have predictive values for prognosis in patients with multiple myeloma.