不同类型多发性骨髓瘤患者的凝血异常分析 及其与血清球蛋白的相关性

Coagulation disorder analysis in patients with different types of multiple myeloma and its correlation with serum globulin

摘要:

目的 探讨不同类型初诊多发性骨髓瘤（MM）患者的凝血指标变化及其与血清球蛋白的相关性。 方法 检测80 例MM 患者（其中轻链型24 例、IgG 型36 例、IgA 型20 例）与38 例健康体检者的凝血指标及 血清球蛋白水平，比较各组间凝血指标变化，并分析其与血清球蛋白相关性。结果 IgA 组和IgG 组MM 患者 的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）高于轻链组和对照组（P <0.05）；各组间纤维蛋白 原（FIB）、凝血酶时间（TT）水平差异无统计学意义（P >0.05）；轻链组D- 二聚体高于IgA 和IgG 组（P <0.05）。 80 例MM 患者中，IgA 组和IgG 组MM 患者的血清球蛋白水平高于轻链组（P <0.05）；血清球蛋白水平与 PT、APTT 呈正相关（r =0.713 和0.613），与D- 二聚体无相关性。结论 MM 患者存在凝血异常，IgA、IgG 型 MM 更易于影响凝血系统，轻链型MM 更倾向形成血栓，且MM 的PT、APTT 异常与血清球蛋白水平相关。

Abstract:

Objective To investigate coagulation disorder and its correlation with serum globulin in different types of patients with primary myeloma (MM). Methods Totally 80 patients with MM (24 cases of light chain type, 36 cases of IgG type, 20 cases of IgA type) and 38 cases of healthy subjects were involved in this study. The blood coagulation indexes and serum globulin levels were measured. Correlation between the indexes of coagulation and serum globulin was determined. Results PT and APTT were upregulated significantly in group IgA and group IgG compared with light chain group and control group (P < 0.05). No significant difference in FIB and TT were identified among all groups (P > 0.05). Patients in Light chain group experienced increased levels of D-dimer compared with IgA and IgG group (P < 0.05). upregulated levels of serum globulin were founded in IgA group and IgG group when compared with light chain group (P < 0.05). Serum levels of globulin were positively correlated with PT and APTT (r = 0.713 and 0.613, respectively) while obvious relationship was suggested between serum globin and D-dimer. Conclusion MM patients with IgA type and IgG type MM are more likely to exert the coagulation dysfunction while patients with light chain type prompt to thrombosis; serum globulin is positively associated with PT and APTT levels.