Poudel Bibek, Mittal Ankush, Shrestha Rojeet, Farooqui Mohammad Shamim, Yadav Naval Kishor, Shukla Pramod Shanker
Department of Biochemistry, Manipal College of Medical Sciences (MCOMS), Manipal Teaching Hospital (MTH), Pokhara, Nepal.
Asian Pac J Cancer Prev. 2012;13(5):2153-5. doi: 10.7314/apjcp.2012.13.5.2153.
This study was to assess liver involvement in multiple myeloma with the aid of liver function tests.
A hospital based retrospective study was undertaken using data retrieved of multiple myeloma from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st January, 2007 and 28th February, 2012. We collected biomarkers of liver profiles including bilirubin (Total, Direct and Indirect), total protein, albumin, AG ratio, SGOT, SGPT, ALP, γGT, LDH, ferritin, renal profile and hematological profile. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software.
Out of 37 cases of multiple myeloma, serum level of AST, ALT, ALP, γGT and LDH were increased above the cut-off point in 22 (59.5%), 24 (64.86%), 13 (35.13%), 9 (24.3%) and 11 (29.7%) respectively. The mean values of AST (65.5±28.18 U/L), ALT (68.37±29.74 U/L), ALP (328.0±148.4 U/L), γGT (44.5±29.6 U/L) and LDH (361.7±116.5 U/L), total protein (9.79±1.03 gm/ dl) were significantly increased when compared with controls. In contrast, albumin (3.68±0.43 gm/dl) and the AG ratio (0.62±0.15) were significantly decreased. Similarly, anemia, hyperuricemia, azotemia, hypercalcaemia and Bence Jones proteinuria were found in 30 (78.9%), 27 (71.1%), 19 (51.5%), 15 (39.5%) and 16 (42.1%) respectively, in cases of multiple myeloma.
While clinical manifestation of liver disease among the multiple myeloma was not common, abnormalities in liver function were characteristic.
本研究旨在借助肝功能检查评估多发性骨髓瘤患者的肝脏受累情况。
开展一项基于医院的回顾性研究，使用从尼泊尔博卡拉马尼帕尔教学医院生物化学科保存的登记册中检索到的2007年1月1日至2012年2月28日期间的多发性骨髓瘤数据。我们收集了肝脏指标的生物标志物，包括胆红素（总胆红素、直接胆红素和间接胆红素）、总蛋白、白蛋白、白球比、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶、乳酸脱氢酶、铁蛋白、肾脏指标和血液学指标。使用EPI INFO和SPSS 16软件进行描述性统计和假设检验以进行分析。
在37例多发性骨髓瘤患者中，血清谷草转氨酶、谷丙转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶和乳酸脱氢酶水平分别有22例（59.5%）、24例（64.86%）、13例（35.13%）、9例（24.3%）和11例（29.7%）高于临界值。与对照组相比，谷草转氨酶（65.5±28.18 U/L）、谷丙转氨酶（68.37±29.74 U/L）、碱性磷酸酶（328.0±148.4 U/L）、γ-谷氨酰转肽酶（44.5±29.6 U/L）和乳酸脱氢酶（361.7±116.5 U/L）、总蛋白（9.79±1.03 gm/dl）的平均值显著升高。相比之下，白蛋白（3.68±0.43 gm/dl）和白球比（0.62±0.15）显著降低。同样，在多发性骨髓瘤患者中，分别有30例（78.9%）、27例（71.1%）、19例（51.5%）、15例（39.5%）和16例（42.1%）出现贫血、高尿酸血症、氮质血症、高钙血症和本周蛋白尿。
虽然多发性骨髓瘤患者中肝脏疾病的临床表现并不常见，但肝功能异常具有特征性。
