摘要
目的 探讨中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)、白细胞介素(IL)-6和IL-37在多发性骨髓瘤(MM)血清中的变化及其对首次治疗疗效的预测价值.方法 回顾性选取2022年1月至2023年6月山西省太原市太原钢铁(集团)有限公司总医院血液内科初诊的采用VRD方案治疗的MM患者50例作为观察组,另选同期体检的健康人群50例作为对照组.分析观察组与对照组血清NLR、MLR、IL-6及IL-37水平的变化.观察组患者按照国际分期体系(ISS)分期分为Ⅰ期(n=12)、Ⅱ期(n=18)、Ⅲ期(n=20);按照疗效分为治疗有效组(n=39)和复发难治组(n=11).进一步分析MM患者不同分期、不同疗效血清NLR、MLR、IL-6及IL-37水平的变化.并分析NLR、MLR、IL-6和IL-37水平对患者首次治疗疗效的预测价值.结果 观察组的NLR、MLR、IL-6水平分别为 1.96±0.69、0.18±0.10、(136.45±48.36)pg/L,均高于对照组[1.41±0.57、0.14±0.05、(28.63±7.57)pg/L],IL-37 水平为(56.89±20.26)ng/L,低于对照组[(118.35±19.38)ng/L],差异均有统计学意义(P＜0.05).随着MM患者分期进展,血清IL-6水平逐步上升,IL-37水平逐步下降,差异均有统计学意义(P＜0.05).治疗有效组患者治疗前的NLR、MLR及IL-6水平均低于复发难治组患者,IL-37水平高于复发难治组的患者,差异均有统计学意义(P＞0.05).Spearman相关性分析结果显示,血清MLR、IL-6水平与MM患者首次治疗有效呈负相关(P＜0.05),血清IL-37水平与MM患者首次治疗有效呈正相关(P＜0.05).ROC曲线显示,治疗前MLR、IL-6及IL-37预测首次治疗有效的AUC值分别为0.787、0.867、0.758.结论 MM患者随着病情的加重,其NLR、MLR及IL-6水平逐渐升高、IL-37逐渐下降,其中MLR、IL-6及IL-37与首次治疗疗效相关,并具有一定的预测价值.
Abstract
Objective To investigate the changes of neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR),interleu-kin(IL)-6 and IL-37 in serum of multiple myeloma(MM)and their predictive value the efficacy of first treatment.Methods In this retro-spective study,50 patients with MM who were initially diagnosed and treated with VRD from January 2022 to June 2023 in the Department of He-matology,Taiyuan Iron & Steel(Group)Co.,LTD.were selected as the study group.Fifty healthy people who underwent physical examination in the authors'hospital during the same period were selected as the control group.The changes of serum NLR,MLR,IL-6 and IL-37 levels in the study group and the control group were analyzed.The observation group patients were divided into stages according to the International Staging System(ISS):stage I(n=12),stage Ⅱ(n=18),and stage Ⅲ(n=20);according to the therapeutic effect,there were divided into the effective treatment group(n=39)and the recurrence refractory group(n=11).And the study group at different stages and different initial treat-ment efficacy were detected,and their predictive value for the first treatment efficacy of patients was analyzed.Results The study group's NLR,MLR,and IL-6 levels were 1.96±0.69,0.18±0.10,and(136.45±48.36)pg/L,respectively,which were higher than those in the control group[1.41±0.57,0.14±0.05,and(28.63±7.57)pg/L],respectively,the level of IL-37 in the study group was(56.89±20.26)ng/L,which was lower than that in the control group[(118.35±19.38)ng/L],the differences were statistically significant(P＜0.05).The ser-um IL-6 level increased gradually and IL-37 level decreased gradually from stage I to stage Ⅲ,and the differences were statistically significant(P＜0.05).Before treatment,the levels of NLR,MLR and IL-6 in the effective treatment group were lower than those in the recurrence refrac-tory group,and the levels of IL-37 in the effective treatment group were higher than those in the recurrence refractory group,and the differences were statistically significant(P＜0.05).Spearman correlation analysis showed that serum MLR and IL-6 levels were negatively correlated with the first treatment effectiveness of MM patients(P＜0.05),and serum IL-37 levels were positively correlated with the first treatment effective-ness of MM patients(P＜0.05).The AUC values of MLR,IL-6 and IL-37 before treatment were 0.787,0.867 and 0.758,respectively.Conclusion With the aggravation of the disease,the levels of NLR,MLR and IL-6 in MM patients gradually increase,and IL-37 gradually decrease.Among them,MLR,IL-6 and IL-37 are correlated with the curative effect of the first treatment,and have certain predictive value.
维普
万方数据