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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。
Objective To detect the levels of serum B lymphocyte activating factor (BAFF) and proliferation-inducing ligand (APRIL) in patients with multiple myeloma (MM) and to explore the relationship between the level of BAFF and APRIL and the occurrence, development and prognosis of MM. Methods A total of 27 cases (43 cases) of MM patients hospitalized in the Department of Hematology of the General Hospital of Shenyang Military Command from April 1, 2012 to February 1, 2013 were collected and peripheral blood samples were collected. The concentration of serum BAFF and APRIL were measured by immunosorbent assay (ELISA). And analyze the differences in the level of MM patients with different genders, different stages, different immunophenotypes and different efficacy, and analyze the correlation between BAFF and APRIL levels and tumor burden indicators. Results (1) The levels of BAFF and APRIL in MM patients were significantly higher than those in normal controls (P<0.05). (2) There was no significant difference in the levels of BAFF and APRIL between MM patients with different genders, different stages, and different immunophenotypes. (3) When the MM patients had different effects, the expression levels in the untreated group and the ineffective group were significantly higher, and there was a statistically significant difference compared with the effective group (P<0.05). The difference in the expression level between the untreated group and the ineffective group was not statistically significant. Meaning. (4) There was a negative correlation between BAFF and APRIL levels and albumin content (P<0.05); there was a positive correlation between BAFF and APRIL levels and bone marrow plasma cell number (P<0.05); APRIL levels were positively correlated with creatinine levels. (P<0.05); There was a positive correlation between BAFF levels and APRIL levels (P<0.05). Conclusions (1) BAFF and APRIL are expressed on the surface of normal B lymphocytes and malignant B lymphocytes, but are highly expressed in MM. (2) When the efficacy of MM patients is different, the expression levels of BAFF and APRIL in the primary and ineffective groups are generally higher. (3) BAFF and APRIL levels can be used as an important reference for evaluating MM tumor burden.