| 多发性骨髓瘤患者合并高钙血症的免疫学特征分析 |
| 投稿时间：2025-01-12 修订日期：2025-02-12 点此下载全文 |
| 引用本文：孟紫璐,郑涵雪,李晓婉,钱怡,李莉娟,张连生.多发性骨髓瘤患者合并高钙血症的免疫学特征分析[J].医学研究杂志,2025,54(7):36-41 |
| DOI：
10.11969/j.issn.1673-548X.2025.07.008 |
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| 基金项目:国家自然科学基金资助项目(82360029)；甘肃省科技计划项目(21JR7RA394,21JR11RA104,21JR7RA435)；甘肃省重点研发计划项目(24YFFA046) |
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| 中文摘要:目的 通过分析比较初诊多发性骨髓瘤(multiple myeloma, MM)合并高钙血症患者与非高钙血症患者的免疫学指标差异,探讨免疫学指标在MM合并高钙血症中的特征、意义及预后价值。方法 本研究对兰州大学第二医院2017年1月～2024年9月收治的241例初诊MM患者的19种免疫学指标进行了回顾性分析,对比MM合并高钙血症组与非高钙血症组患者及MM合并不同程度的高钙血症患者间免疫学指标的差异,以探究免疫机制对其的影响及意义。结果 与非高钙血症组患者比较,MM合并高钙血症组患者血清白介素(interleukin,IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-10、IL-12p70、干扰素(interferon,IFN)-α及IFN-γ水平更高,CD4+T淋巴细胞比例及CD4+/CD8+比值更低,差异有统计学意义(P＜0.05)。对3种不同程度高钙血症患者的免疫指标进行对比分析发现,随着血钙浓度的升高,Treg比值及CD4+/CD8+值逐级降低,差异有统计学意义(P＜0.05)。结论 MM合并高钙血症组患者免疫学指标异常更为明显,提示该组患者存在更为严重的免疫微环境紊乱,这不仅为较差的预后判断提供了新的指标,也为下一步个体化免疫治疗提供了依据。 |
| 中文关键词:多发性骨髓瘤 高钙血症 免疫学指标 |
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| Immunological Characteristics of Multiple Myeloma Patients with Hypercalcemia. |
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| Abstract:Objective To investigate the characteristics and prognostic significance of immunological indexes in patients with hypercalcemia in multiple myeloma(MM). Methods A retrospective analysis of 241 newly diagnosed multiple myeloma(NDMM) admitted to the Second Hospital of Lanzhou University from January 2017 to September 2024 was conducted to compare the differences of 19 immunological indicators between hypercalcemia and non-hypercalcemia group and in patients with mild, moderate and severe hypercalcemia, so as to explore the influence and significance of immune mechanism on it. Results Compared with patients without hypercalcemia, patients with MM complicated with hypercalcemia had higher levels of serum IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IFN-α and IFN-γ, lower CD4+T lymphocyte ratio and CD4+/CD8+ratio, and statistically significant differences(P<0.05). Comparative analysis of immune indicators in patients with three different degrees of hypercalcemia revealed that as blood calcium concentration increased, the Treg ratio and CD4+/CD8+values gradually decreased, with statistically significant differences(P<0.05). ConclusionThe results of this study showed that the immunological indexes of hypercalcemia patients were more abnormal than patients without in MM, suggesting that patients in this group had more disturbed immune microenvironment, which not only provided new indicators for poor prognosis, but also provided reference for future individualized immunotherapy. |
| keywords:Multiple myeloma Hypercalcemia Fine immune indices |
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