| Objective:In this study,the expression of epinephrine ? 2 receptor in bone marrow of multiple myeloma was detected,and the clinical data and cardiac damage of multiple myeloma were analyzed to find out the relationship between adrenaline? 2 receptor and the occurrence of multiple myeloma.In order to provide theoretical basis for the treatment of multiple myeloma with ? receptor blocker,improve the prognosis of multiple myeloma and provide reference for diagnosis and treatment..Methods:1.The clinical data of 51 patients with multiple myeloma were collected from July 2012 to December 2017.The measured data were expressed as x ± s,and the clinical data of 51 patients with mm were analyzed and summarized,including age,sex,stage,clinical symptoms.The correlation between single factor and median survival time of patients with multiple myeloma was analyzed by product limit method.The main factors included age,clinical stage and classification,hemoglobin,serum albumin.Creatinine,? 2-microglobulin,lactate dehydrogenase,serum calcium,erythrocyte sedimentation rate and plasma cell ratio in bone marrow smears.The survival conditions of different groups were compared by bilateral log-rank test.Finally,the multivariate analysis of cox proportional risk regression model was used.To observe the curative effect and side effects of cyclophosphamide combined with dexamethasone and thalidomide in the treatment of 10 newly diagnosed elderly patients with multiple myeloma.Tumor patients as observation group(excluding patients with basic heart disease and cor pulmonale),The results of echocardiography were compared with that of 20 normal controls(all of whom were excluded from cardiopulmonary disease by physical examination in our hospital),and the manifestations of cardiac damage in the course of disease were reviewed.There was no significant difference in age and sex ratio between the two groups(P>0.05).At the same time,the causes of death were analyzed..2.2.The adrenaline ? 2 receptor in bone marrow of multiple myeloma was detected by immunohistochemical method.All the patients in the experimental group and the control group were well informed consent to bone marrow puncture and biopsy.The experimental group(n = 14)was a newly diagnosed multiple myeloma patient(n = 5)and the control group(n = 5)had no abnormal bone marrow by bone marrow cytology and pathological examination.The nonparametric rank sum test was used in statistics,and the difference was statistically significant(p<0.05)..Result:1.General clinical data:(1)51 patients with MM,26 were male(51%)and 25 were female(49%);aged 36-79 years,median age of onset was 61 years,and immunophenotype was IgG type The most common,accounting for 45.1%,mainly in patients with stage ? disease.(2)Univariate analysis showed that hemoglobin,serum albumin,creatinine,and ?2-microglobulin were associated with MM prognosis,but the age of onset,stage,and type,ratio of bone marrow plasma cells,serum calcium ion,and ESR did not correlate with prognosis.The COX multivariate analysis suggested that hemoglobin,?2-microglobulin,albumin,and creatinine had influence on the prognosis(P values were 0.032,0.037,0.028,and 0.044).2.10 cases of elderly patients with MM using TCD regimen,after 10 cycles of treatment for 2 cycles,complete remission in 3 cases,including IgG in 3 cases;partial remission(PR)in 6 cases,PR rate in 60%,including IgG in 3 cases,There were 2 cases of IgA type,1 case of light chain type,1 case of ineffective(NC)1 case,and 1 case of light chain type.During the treatment,toxic side effects were mild and no treatment-related deaths occurred.3.The left atrial diameter,right atrial diameter,right ventricular diameter and left ventricular posterior wall thickness in the experimental group were significantly higher than those in the control group(P<0.05).In the course of disease,5 cases of heart failure,1 case of angina pectoris,8 cases of sinus bradycardia,2 cases of sinus velocity,3 cases of atrial fibrillation and 4 cases of pericardial effusion were observed.8 patients with sinus bradycardia were treated with high dose dexamethasone.The heart rate and electrocardiogram were observed and returned to normal after stopping..4.The detection of ?2-AR in bone marrow of MM patients by immunohistochemistry showed that all myeloma cells were positively located in the cell membrane and cytoplasm and turned brown or brown particles,In normal patients,bone marrow tissue plasma cells were expressed in all 5 patients and all were weakly positive(+).Fourteen MM patients had expression,of which 3 were moderately positive(++)and the remaining 11 were strongly positive(+++).There was a difference in p2-AR between the two(Z=-3.65,P=0.000,P<0.05).Conclusion:1.51 cases of mm patients in our hospital were mainly in iii stage,and igg was the main type of immunological typing.The results of univariate and multivariate prognostic analysis showed that hemoglobin,? 2-microglobulin,serum albumin,and so on.Creatinine can be used as a first-line regimen for predicting prognosis in newly diagnosed elderly patients with multiple myeloma.Cardiac damage is one of the common complications of multiple myeloma and one of the most common causes of death.Routine echocardiography is helpful for early identification of cardiac damage in multiple myeloma,adjustment of treatment and prognosis..2.The expression of ?2-AR in myeloma cells of normal myeloid tissue and myeloma of multiple myeloma was observed.The expression of ?2-AR in myeloma cells was significantly higher than that of normal plasma in myeloma.There is a difference between them.The significance of P-adrenoceptor blocker therapy in patients with multiple myeloma may be further explored. |
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