CAJ | 학술논문

目的：检测多发性骨髓瘤（MM）患者血清 B 淋巴细胞活化因子（BAFF）和增殖诱导配体（APRIL）水平，探讨BAFF、APRIL水平与MM的发生发展以及预后的关系。方法收集2012年4月1日至2013年2月1日于沈阳军区总医院血液科住院的27例（43例次）MM患者和48例正常对照组的外周血标本，提取血清，采用酶联免疫吸附试验（ELISA）法检测血清BAFF和APRIL的浓度。并分析其水平在不同性别、不同分期、不同免疫分型及不同疗效时MM患者中的差异，分析BAFF和APRIL水平之间及与肿瘤负荷指标之间的相关性。结果（1）MM患者BAFF和APRIL水平明显增高，与正常对照组相比，差异有统计学意义（P＜0.05）。（2）MM患者不同性别、不同分期及不同免疫分型之间对比，BAFF及APRIL水平差异无统计学意义。（3）MM 患者不同疗效时，初治组和无效组表达水平明显增高，与有效组比较，差异有统计学意义（P＜0.05）；初治组与无效组之间表达水平的差异无统计学意义。（4）BAFF、APRIL水平与白蛋白含量之间呈负相关（P＜0.05）；BAFF、APRIL水平与骨髓浆细胞数之间呈正相关（P＜0.05）；APRIL水平与肌酐含量之间呈正相关（P＜0.05）；BAFF水平与APRIL水平之间呈正相关（P＜0.05）。结论（1）BAFF、APRIL在正常B淋巴细胞和恶性B淋巴细胞表面都表达，但在MM高表达。（2）MM患者疗效不同时，初治和无效组 BAFF、APRIL 表达水平普遍更高。（3）BAFF、APRIL 水平可作为评估MM肿瘤负荷量的重要参考指标。
목적：검측다발성골수류（MM）환자혈청 B 림파세포활화인자（BAFF）화증식유도배체（APRIL）수평，탐토BAFF、APRIL수평여MM적발생발전이급예후적관계。방법수집2012년4월1일지2013년2월1일우침양군구총의원혈액과주원적27례（43례차）MM환자화48례정상대조조적외주혈표본，제취혈청，채용매련면역흡부시험（ELISA）법검측혈청BAFF화APRIL적농도。병분석기수평재불동성별、불동분기、불동면역분형급불동료효시MM환자중적차이，분석BAFF화APRIL수평지간급여종류부하지표지간적상관성。결과（1）MM환자BAFF화APRIL수평명현증고，여정상대조조상비，차이유통계학의의（P＜0.05）。（2）MM환자불동성별、불동분기급불동면역분형지간대비，BAFF급APRIL수평차이무통계학의의。（3）MM 환자불동료효시，초치조화무효조표체수평명현증고，여유효조비교，차이유통계학의의（P＜0.05）；초치조여무효조지간표체수평적차이무통계학의의。（4）BAFF、APRIL수평여백단백함량지간정부상관（P＜0.05）；BAFF、APRIL수평여골수장세포수지간정정상관（P＜0.05）；APRIL수평여기항함량지간정정상관（P＜0.05）；BAFF수평여APRIL수평지간정정상관（P＜0.05）。결론（1）BAFF、APRIL재정상B림파세포화악성B림파세포표면도표체，단재MM고표체。（2）MM환자료효불동시，초치화무효조 BAFF、APRIL 표체수평보편경고。（3）BAFF、APRIL 수평가작위평고MM종류부하량적중요삼고지표。
Objective To detect the concentrations of serum B cell activating factor (BAFF) and aproliferation-inducing ligand(APRIL) and explore the correlation between the levels of BAFF and APRIL and the occurrence, development and prognosis of MM. Methods Peripheral blood samples were collected from 27 patients(43 cases) with MM and from 48 normal people as control. Then the serum were extracted and the concentrations of serum BAFF and APRIL were detected by using enzyme-linked immunosorbent assay. Analysis the difference at different gender, stages, immunophenotype and effects in multiple myeloma(MM).Meanwhile, to analysis the relationship between BAFF(or APRIL) and tumor burden indicators. Results (1) The level of BAFF and APRIL were higher in MM group;Compared with normal control group, there was significant difference(P<0.05). (2) There was no significant difference with the level of BAFF and APRIL at different gender, stages, immunophenotype and effects in MM. (3) The level of BAFF and APRIL were higher in the newly diagnosed group and the ineffective group; Compared with the effective group, there was significant difference(P<0.05);. There was no significant difference between the newly diagnosed group and the ineffective group. (4) The levels of BAFF and APRIL negatively correlated with albumin(P<0.05); The levels of BAFF and APRIL positively correlated with percent of plasma cell in bone marrow(P<0.05);The levels of APRIL positively correlated with the serum creatinine(P<0.05); The levels of BAFF positively correlated with the levels of APRIL(P<0.05). Conclusion The level of BAFF and APRIL were higher in MM. The level of BAFF and APRIL were higher in the newly diagnosed group and the ineffective group. The level of BAFF and APRIL could be an important indicator for evatuating the tumor burden of MM.