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目的:研究血液红系参数和胱抑素C(cystatin C,CysC)的联合检测观察多发性骨髓瘤(multiple myeloma,MM)患者贫血病变程度的价值。方法:对56例MM初发住院患者进行相关实验室检查,根据血红蛋白(hemoglobin,HGB)水平分为3组:A组(HGB 43～75 g/L)18例,B组(HGB 76～98 g/L)19例,C组(HGB 101～146 g/L)19例。结果:3组之间的平均红细胞客积、平均血球血红蛋白、平均血球血红蛋白浓度各项目比较均无统计学意义(P>0.05)。A组、B组的红细胞分布宽度(red celldistribution width,RDW)、CysC均明显高于C组(P<0.001或P<0.01),A组和B组之间无明显差异(P>0.05);A组、B组的RDW、CysC阳性检出率明显高于C组(P<0.001或P<0.01),A组和B组之间也无明显差异(P>0.05)。56例患者的RDW、CysC分别与HGB呈明显负相关关系(r=-0.525,P<0.01;r=-0.553,P<0.01)。以C组为非明显贫血对照的ROC分析提示,RDW、CysC的曲线下面积(area under curve,AUC)分别为0.827、0.892,双因素下的AUC则可提高至0.946。结论:MM患者的明显贫血改变与RDW、CysC的升高有关,但在的贫血进程中升高不显著。血液指标RDW、CysC的检测能为研究MM患者相关贫血机制提供重要的临床依据。
Objective: To study the value of hematological erythroid parameters and cystatin C (CysC) in the detection of anemia in patients with multiple myeloma (MM). Methods: Fifty-six patients with MM initial hospitalization were divided into three groups according to hemoglobin (HGB) level: 18 cases in group A (HGB 43-75 g / L), and group B (HGB 76-98 19 cases in group C and 19 cases in group C (HGB 101-146 g / L). Results: There was no significant difference in mean hematocrit, mean hemoglobin and mean hemoglobin between the three groups (P> 0.05). The red cell distribution width (RDW) and CysC of group A and group B were significantly higher than those of group C (P <0.001 or P <0.01), but there was no significant difference between group A and group B (P> 0.05). The positive rates of RDW and CysC in group A and group B were significantly higher than those in group C (P <0.001 or P <0.01). There was no significant difference between group A and group B (P> 0.05). 56 cases of patients with RDW, CysC were significantly negative correlation with HGB (r = -0.525, P <0.01; r = -0.553, P <0.01). ROC analysis showed that the area under curve (AUC) of RDW and CysC were 0.827 and 0.892, respectively. The AUC of two factors could be increased to 0.946. Conclusion: The significant changes of anemia in patients with MM are related to the elevation of RDW and CysC, but not significant in anemia. The detection of blood markers RDW and CysC can provide an important clinical basis for the study of anemia related mechanism in MM patients.