Zhao Bing-Ni, Dong Chun-Xia, Kang Jian-Min, Ge Xiao-Yann, Zhang Jian-Hua, Wang Mei-Fang, Yang Lin-Hua
Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Aug;31(4):1100-1107. doi: 10.19746/j.cnki.issn.1009-2137.2023.04.026.
To analyze the clinical characteristics of venous thromboembolism (VTE) in patients with multiple myeloma (MM) and to identify the risk factors of VTE in MM patients.
179 newly diagnosed MM (NDMM) patients admitted to The Second Hospital of Shanxi Medical University from January 2014 to December 2020 who were followed up for more than 6 months were collected, and they were divided into VTE group and control group according to whether combined with VTE. The clinical and laboratory data were compared between the two groups. Mann-whitney U test was used for inter-group comparison of measurement data, Chi-square test or Fisher's exact test was used for inter-group comparison of count data, and multivariate logistic regression analysis was performed to explore the risk factors of VTE in MM patients.
Compared with control group, the serum albumin (ALB) level in VTE group was significantly lower ( =0.033), the fibrinogen (FIB) level was significantly higher ( =0.016), and the proportion of patients with D-dimer≥2 000 ng/ml was significantly higher than that in the control group (26.3% 4.4%, =0.002). There was a significant difference in M-component type between the two groups ( =0.028), and the proportion of IgG type in VTE group was higher. There were no statistically significant differences between two groups in age, sex, body mass index (BMI), the proportions of patients with hypertension, diabetes, coronary heart disease and cerebral infarction, white blood cell (WBC) count, platelet (PLT) count, liver and kidney function, plasma cells ratio in bone marrow, serum globulin (GLO), lactate dehydrogenase (LDH), β-microglobulin (β-MG) level, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), prothrombin time (PT), activated partial thromboplastin time (APTT), disease stage, thrombosis prevention and the use of immunomodulators ( >0.05). Multivariate logistic regression analysis showed that FIB level (=1.578, 95%:1.035-2.407, =0.034), D-dimer≥2 000 ng/ml (=5.467, 95%:1.265-23.621, =0.023) and IgG type (=4.780, 95%: 1.221-18.712, =0.025) were independent risk factors for VTE in MM patients.
MM patients are prone to VTE, and FIB level, D-dimer≥2 000 ng/ ml and IgG type are independent risk factors for VTE in MM patients.
分析多发性骨髓瘤（MM）患者静脉血栓栓塞症（VTE）的临床特征，并确定MM患者发生VTE的危险因素。
收集2014年1月至2020年12月在山西医科大学第二医院收治的179例新诊断MM（NDMM）患者，这些患者均接受了超过6个月的随访，并根据是否合并VTE分为VTE组和对照组。比较两组的临床和实验室数据。计量资料组间比较采用Mann-whitney U检验，计数资料组间比较采用卡方检验或Fisher确切检验，并进行多因素logistic回归分析以探索MM患者发生VTE的危险因素。
与对照组相比，VTE组血清白蛋白（ALB）水平显著降低（P = 0.033），纤维蛋白原（FIB）水平显著升高（P = 0.016），D-二聚体≥2 000 ng/ml的患者比例显著高于对照组（26.3%对4.4%，P = 0.002）。两组间M蛋白类型存在显著差异（P = 0.028），VTE组IgG型比例更高。两组在年龄、性别、体重指数（BMI）、高血压、糖尿病、冠心病和脑梗死患者比例、白细胞（WBC）计数、血小板（PLT）计数、肝肾功能、骨髓浆细胞比例、血清球蛋白（GLO）、乳酸脱氢酶（LDH）、β-微球蛋白（β-MG）水平、C反应蛋白（CRP）水平、红细胞沉降率（ESR）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、疾病分期、血栓预防及免疫调节剂使用方面差异均无统计学意义（P>0.05）。多因素logistic回归分析显示，FIB水平（P = 1.578，95%CI：1.035 - 2.407，P = 0.034）、D-二聚体≥2 000 ng/ml（P = 5.467，95%CI：1.265 - 23.621，P = 0.023）和IgG型（P = 4.780，95%CI：1.221 - 18.712，P = 0.025）是MM患者发生VTE的独立危险因素。
MM患者易发生VTE，FIB水平、D-二聚体≥2 000 ng/ml和IgG型是MM患者发生VTE的独立危险因素。
