CAJ | 학술논문

目的：探讨初诊多发性骨髓瘤患者凝血指标的变化及意义。方法回顾性分析2008年10月-2012年10月中国医科大学附属第一医院血液科收治的初诊多发性骨髓瘤患者96例，检测凝血酶原时间（PT）、部分活化的凝血活酶时间（APTT）、纤维蛋白原（Fg）水平。并分析凝血指标的变化与一般资料、疾病分期、肝功能指标、M 蛋白水平的关系。结果96例患者中，单纯 PT 延长的患者25例，单纯 APTT 延长的患者5例，PT 及 APTT 同时延长的患者11例。96例患者中 PT 延长组36例，非 PT 延长组60例，两组患者性别、年龄及丙氨酸氨基转移酶（ALT）、γ谷氨酰转肽酶（γ- GT）、总胆红素（TBIL）水平比较，差异均无统计学意义（P >0.05）；两组 DS 分期、ISS 分期及 Fg水平比较，差异均有统计学意义（P <0.05）。PT 延长组 IgA 型和 IgG 型患者 M 蛋白水平较非 PT 延长组升高（P <0.05）。IgA 型和 IgG 型患者 PT 与 M 蛋白水平均呈正相关（r 值分别为0.619和0.664，P <0.05）。结论在初诊的多发性骨髓瘤患者中，PT 延长多见于 DS 分期和 ISS 分期Ⅲ期患者，且在 IgA 及 IgG 两型患者中合并 M 蛋白水平明显升高，并与 PT 呈正相关。
목적：탐토초진다발성골수류환자응혈지표적변화급의의。방법회고성분석2008년10월-2012년10월중국의과대학부속제일의원혈액과수치적초진다발성골수류환자96례，검측응혈매원시간（PT）、부분활화적응혈활매시간（APTT）、섬유단백원（Fg）수평。병분석응혈지표적변화여일반자료、질병분기、간공능지표、M 단백수평적관계。결과96례환자중，단순 PT 연장적환자25례，단순 APTT 연장적환자5례，PT 급 APTT 동시연장적환자11례。96례환자중 PT 연장조36례，비 PT 연장조60례，량조환자성별、년령급병안산안기전이매（ALT）、γ곡안선전태매（γ- GT）、총담홍소（TBIL）수평비교，차이균무통계학의의（P >0.05）；량조 DS 분기、ISS 분기급 Fg수평비교，차이균유통계학의의（P <0.05）。PT 연장조 IgA 형화 IgG 형환자 M 단백수평교비 PT 연장조승고（P <0.05）。IgA 형화 IgG 형환자 PT 여 M 단백수평균정정상관（r 치분별위0.619화0.664，P <0.05）。결론재초진적다발성골수류환자중，PT 연장다견우 DS 분기화 ISS 분기Ⅲ기환자，차재 IgA 급 IgG 량형환자중합병 M 단백수평명현승고，병여 PT 정정상관。
Objective To discuss the changes and clinical significance of coagulation index in patients of newly diag-nosed multiple myeloma. Methods The clinical data of 96 patients with newly diagnosed multiple myeloma who were treated in Department of Hematology,the First Hospital of China Medical University,from October 2008 to October 2012,was analyzed retrospectively,APTT,PT and Fg level were detected. The relationship between the the changes of coagulation index and the gen-eral information,stage of disease,liver function index,the level of M protein was analyzed. Results Among 96 patients,25 pa-tients had prolonged PT alone,5 had prolonged APTT alone,11 had both prolonged PT and APTT. Among 96 patients,36 were included in prolonged PT group,60 were included in non - prolonged PT group,there was no significant difference in gender, age,ALT level,γ - GT level and TBIL level between two groups(P > 0. 05). There were significant differences in stage of DS, stage of ISS and level of Fg between two groups(P < 0. 05). M protein levels of IgA type patients and IgG type patients in pro-longed PT group were significantly higher than those in non - prolonged PT group,the differences were statistically significant(P< 0. 05). The level of M protein was positively correlated with PT among both IgA type patients and IgG type patients(r = 0. 619 and 0. 664 respectively,P < 0. 05). Conclusion Prolonged PT commonly exists in the newly diagnosed multiple myeoloma withⅢ stage of DS and ISS,prolonged PT and high level of M protein commonly exist in IgA type patients and IgG type patients. The level of M protein in these two types of patients with prolonged PT was positively correlated with PT.