多发性骨髓瘤临床分期与预后指标相关性分析-内科学专业论文.docxVIP

— — PAGE 1— 摘 要 多发性骨髓瘤临床分期与预后指标的相关性分析 研究生：李国嫱 导师：王晓敏教授 摘 要 目的：多发性骨髓瘤(multiple myeloma, MM )是一种异质性浆细胞瘤，预后不良， 本文探讨了MM患者临床特点，了解了不同民族的多发性骨髓瘤患者的临床分期, 比 较预后相关参数与Durie-Salmon (DS) 分期、International Staging System ( ISS) 分期 的相关性。方法：对我院68例多发性骨髓瘤患者的临床资料进行回顾性分析。结果： 汉族中位发病年龄66岁，维吾尔族58岁；均以男性为主，分型以IgG型为主；66.2% 患者处于Durie-Salmon分期Ⅲ期，58.8%患者处于International Staging System分期； DS分期与ISS分期具有良好的相关性(P≤0. 05) ; 血红蛋白(Hb)、β2-微球蛋白(β2-M G)、白蛋白(ALB)、血小板（PLT）、血肌酐(Scr)与DS分期及ISS分期均相关(P 均≤0. 05) ;结论：维吾尔族患者较汉族患者发病年龄较年轻，大多数患者就诊时处于DS分 期及ISS分期的Ⅲ期，ISS分期较DS分期简单易行, ISS分期病人分配平均，同样能较 好地反映体内瘤负荷及预后, 但ISS分期对未分泌型及预后差患者分期不准，需进一 步完善。动态测定HB、Scr、B2-M G、ALB 对治疗和预后判断有一定的指导意义。 关键词：多发性骨髓瘤；分期系统；预后 新疆医科大学医学硕士学位论文 The correlation between the prognosis relative index and clinic stages on multiplemyeloma patients Postgraduate: Li Guoqiang Supervisor: Prof.Wang Xiaomin Abstract Objective: Multiple myeloma (MM)is a heterogeneous disease of plasma cell tumor with poor progonosis .To analyses the presenting feature and laboratory features of the patients with multiple myeloma .To study the clinic stages of multiple myeloma of diffent race, compare the Durie-Salmon (DS) stage with International Staging System ( ISS) stage. Methods: Retrospective study applied to analyze the clinic data of 68 multiple myeloma (MM ) cases. Results: Of the Han people patients ,the median age were 66, Of the uygur nationality patients ,the median age were 58,male predominant.IgG was the commonest type.66.2% of the patients are diagnosed on stage Ⅲ according to Durie-Salmon, 58.8% of the patients are diagnosed on stage Ⅲ according to International Staging System ( ISS) stage.The DS stage significantly correlated with ISS stage (P 0. 05) ; The levels of hemoglobin (Hb) , B2-microglobulin (B2-M G) , serum creatinine (Scr) , blood platelet significantly correlated with the DS stage and ISS stage (P 0. 05). Conclusion: Compared with those of Han people, the patients with the uygur nationality are relatively younger,The ISS stage could be a simple altern