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  • Title: [Coagulation Indexes and Their Prognostic Significance in Patients with Multiple Myeloma].
    Author: Li QF, Zhang QK, Wei XF, Feng YF.
    Journal: Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2021 Jun; 29(3):791-796. PubMed ID: 34105474.
    Abstract:
    OBJECTIVE: To analyze the relationship between coagulation indexes and prognosis of patients with multiple myeloma (MM). METHODS: A total of 99 newly diagnosed MM patients treated in Gansu Provincial Hospital from October 2017 to October 2019 were enrolled. Plasma thromboplastin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT), and other laboratory indexes were detected. The relationship between coagulation indexes and clinical characteristics of MM patients was analyzed. The differences in survival rates among MM patients with different levels of coagulation indexes were compared, and the effect of each clinical index on the prognosis of MM patients was analyzed by univariate and multivariate. RESULTS: Each coagulation index was correlated to sex, disease classification and stage, and β2-MG level of MM patients. Disease stage and β2-MG level were positively correlated with coagulation indexes, which means that patients with late-stage disease or high β2-MG, IgA and IgG levels were more likely to develop into coagulation disorders (P<0.05). The survival rate of patients with MM exhibiting elevated PT, FIB, and D-D levels was significantly lower (P<0.05). Univariate and multivariate analysis showed that each coagulation index was the influencing factor on the follow-up outcomes of MM patients, in which FIB was an independent prognostic factor. CONCLUSION: Coagulation function is correlated with multiple clinical indicators of patients with MM and plays an important role in their prognosis. 题目: 多发性骨髓瘤患者凝血指标水平及预后意义. 目的: 分析多发性骨髓瘤（MM）患者凝血指标水平及其与预后的关系. 方法: 选取甘肃省人民医院2017年10月至2019年10月初诊MM患者99例，检测血浆凝血活酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、D－二聚体（D-D）、血小板（PLT）等实验室指标水平，分析各凝血指标与MM患者临床参数的相关性；比较各凝血指标不同水平MM患者生存率的差异，单因素及多因素分析各临床指标对MM预后的影响. 结果: 各凝血指标与MM患者性别、疾病分型、分期及β2-MG等存在相关性，其中，疾病分期、β2-MG与凝血指标水平呈正相关，即分期越晚、β2-MG偏高的IgA及IgG型男性患者更易出现凝血紊乱（P<0.05）； PT、FIB及D-二聚体升高的MM患者生存率更低（P<0.05）；单因素及多因素分析显示各凝血指标对患者随访结局有影响，其中FIB为独立预后因素. 结论: 凝血功能与MM患者多项临床指标存在相关性，并对患者预后有重要作用.
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