摘要
目的探讨多发性骨髓瘤(MM)患者血栓弹力图(TEG)特点。方法选取2020年5月至2021年11月血液内科病房收治的111例MM患者,均进行TEG检测,以轻链类型、M蛋白类型、M蛋白水平、球蛋白水平、β2-微球蛋白(β2-MG)水平、血红蛋白(Hb)水平、血小板计数(PLT)进行不同分组,分析TEG的主要参数:R值、K值、Angle值、MA值。结果以轻链类型κ、λ、无蛋白分3组,各参数比较差异无统计学意义(P>0.05);M蛋白类型以IgA、IgG、游离轻链型、含两种类型和无M蛋白分5组,仅Angle比较差异有统计学意义(P<0.05);M蛋白水平按0、>0~10、>10~30、>30~50、>50~80,>80 g/L分6组,K、Angle两项比较差异有统计学意义(P<0.05);球蛋白水平按≤35、>35 g/L分2组,各参数比较差异无统计学意义(P>0.05);β2-MG按<3.5、3.5~5.5、>5.5 g/L分3组,仅Angle比较差异有统计学意义(P<0.05);Hb水平按<60、>60~90、>90~120、>120 g/L分4组,各参数比较差异无统计学意义(P>0.05);PLT按<100×10^(9)/L、(100~300)×10^(9)/L、>300×10^(9)/L分3组,R、K、Angle、MA差异有统计学意义(P<0.05),其中K、Angle、MA差异极显著(K、Angle极显著级别低于MA)。结论MM患者存在凝血功能异常,M蛋白水平与纤维蛋白形成情况呈负相关(K正相关、Angle负相关),即M蛋白水平越高,纤维蛋白形成/织网速度越慢。血小板在整个凝血过程中均参加,起着关键作用(启动凝血R、纤维蛋白形成K/Angle、凝血块强度MA),随着病程进展,出血风险可能增加。
Objective To investigate the characteristics of thromboelastogram(TEG)in patients with multiple myeloma(MM).Methods A total of 111 MM patients admitted to the department of hematology from May 2020 to November 2021 were selected for TEG detection.They were divided into different groups according to light chain type,M protein type,M protein level,globulin level,β2-microglobulin(β2-MG)level,hemoglobin(Hb)level and platelet count(PLT).Analyze the main parameters of TEG,including R value,K value,Angle value and MA value.Results Patients with MM were classified by light chain typeκ,λand no protein,but there was no difference in TEG(P>0.05).M protein types were divided into 5 categories,including IgA,IgG,free light chain type,containing two types and no M protein.Only Angle had statistical significance in TEG index(P<0.05).M protein level was divided into 6 groups according to 0,>0-10,>10-30,>30-50,>50-80,>80 g/L.K,Angle difference was significant in TEG(P<0.05).The globulin level was divided into two groups,≤35,>35 g/L,and there was no difference in TEG(P>0.05).β2-MG was divided into three groups:<3.5,3.5-5.5,>5.5 g/L,and only Angle in TEG had statistical significance(P<0.05).Hemoglobin level was divided into four groups:<60,>60-90,>90-120,>120 g/L and there was no difference in TEG(P>0.05).PLT was divided into three groups:<100×10^(9)/L,(100-300)×10^(9)/L and>300×10^(9)/L.The differences of R,K,Angle and MA in TEG were significant(P<0.05),among which the differences of K,Angle and MA were extremely significant(K and Angle were significantly lower than MA).Conclusion Patients with MM had abnormal coagulation function,and M protein level was negatively correlated with fibrin formation(positively correlated with K and negatively correlated with Angle).That is,the higher the level of M protein,the slower the rate of fibrin formation/netting.Platelets participate in the whole coagulation process and play a key role(coagulation initiation R,fibrin formation K/Angle,clot intensity MA).The risk of bleeding may increase as the disease progresses.
作者
刘娴
黄丽芳
李春蕊
肖敏
汪智琼
LIU Xian;HUANG Lifang;LI Chunrui;XIAO Min;WANG Zhiqiong(Department of Hematology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China)
出处
《检验医学与临床》
CAS
2022年第S01期85-89,共5页
Laboratory Medicine and Clinic
关键词
多发性骨髓瘤
血栓弹力图
凝血功能
multiple myeloma
thrombelastography
coagulation function
