Fu Yuan, Wei Xiao-Fang, Feng You-Fan, Liu Fei, Chen Qiao-Lin, Zhao Yang-Yang, Zhang Wen-Jie, Ma Ting, Huang Xiu-Juan, Chen Yang, Li Qing-Fen, Zhang Qi-Ke
Department of Hematology,Gansu Provincial Hospital,Lanzhou 730700,Gansu Province,China.
Department of Hematology,Gansu Provincial Hospital,Lanzhou 730700,Gansu Province,China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Apr;29(2):530-534. doi: 10.19746/j.cnki.issn.1009-2137.2021.02.035.
To analyze the influence of serum homocysteine (Hcy) levels to the prognosis of newly diagnosed multiple myeloma (MM) patients, and to explore related factors affecting the prognosis of the patients.
The clinical pathological data of 180 newly diagnosed MM patients treated in our hospital from March 2013 to February 2015 were collected, and the patients were divided into high and low Hcy groups based on the median Hcy. The survival curves of the patients in the two groups were drawn to compare the differences of the survival; univariate and multivariate survival analysis was used to observe the influence of serum cysteine to the prognosis of newly diagnosed MM patients; the clinicopathological data of the patients with high and low Hcy in the two groups was compared, Pearson test was used to further analyzes the relationship between Hcy and different factors, and explores the related factors of Hcy affecting the prognosis of the patients.
The median survival times of patients in the high and low Hcy groups were 32 (5-59) and 41 (7-71) months, respectively. The 3-year survival rate of the patients in high Hcy group was significantly lower than those in low Hcy group, and the difference shows statistically significant (P<0.05). The results of univariate survival analysis showed that the OS of newly diagnosed MM patients whom with advanced age, high bone disease grade, high-level bone marrow plasma cell count, LDH, C-reactive protein, Cr, β-MG, Hcy, low-level Hb, and ALB was significantly shortened (all P<0.05). The results of multivariate survival analysis showed that old age, high levels of bone marrow plasma cells, Cr, β-MG, low levels of Hb, and ALB were the independent risk factors shorting the overall survival (OS) time of newly diagnosed MM patients (all P<0.05), while Hcy showed no independent relation for the OS of patients (P>0.05). The Hb level of the patients in high Hcy group was significantly lower than those in low-Hcy group, while the LDH level was significantly higher than those in low Hcy group (all P<0.05). Pearson test results showed that serum Hcy and Hb showed negative correlation (r=-0.813, P<0.05), but it shows positive correlation with LDH (r=0.726, P<0.05).
Serum Hcy level has a correlation trend with the survival of newly diagnosed MM, which is affected by factors such as Hb.
分析血清同型半胱氨酸（Hcy）水平对新诊断的多发性骨髓瘤（MM）患者预后的影响，并探讨影响患者预后的相关因素。
收集2013年3月至2015年2月在我院治疗的180例新诊断MM患者的临床病理资料，根据Hcy中位数将患者分为Hcy高水平组和低水平组。绘制两组患者的生存曲线以比较生存差异；采用单因素和多因素生存分析观察血清半胱氨酸对新诊断MM患者预后的影响；比较两组Hcy高水平和低水平患者的临床病理资料，采用Pearson检验进一步分析Hcy与不同因素之间的关系，并探讨影响患者预后的Hcy相关因素。
Hcy高水平组和低水平组患者的中位生存时间分别为32（5 - 59）个月和41（7 - 71）个月。Hcy高水平组患者的3年生存率显著低于低水平组，差异有统计学意义（P<0.05）。单因素生存分析结果显示，年龄较大、骨病分级高、骨髓浆细胞计数高、乳酸脱氢酶（LDH）、C反应蛋白、肌酐（Cr）、β2微球蛋白（β-MG）、Hcy高水平、血红蛋白（Hb）和白蛋白（ALB）低水平的新诊断MM患者的总生存期（OS）显著缩短（均P<0.05）。多因素生存分析结果显示，年龄大、骨髓浆细胞水平高、Cr、β-MG、Hb和ALB低水平是缩短新诊断MM患者总生存（OS）时间的独立危险因素（均P<0.05），而Hcy对患者的OS无独立相关性（P>0.05）。Hcy高水平组患者的Hb水平显著低于低水平组患者，而LDH水平显著高于低水平组患者（均P<0.05）。Pearson检验结果显示，血清Hcy与Hb呈负相关（r = -0.813，P<0.05），但与LDH呈正相关（r = 0.726，P<0.05）。
血清Hcy水平与新诊断MM患者的生存存在相关趋势，其受Hb等因素影响。
