目的: 检测多发性骨髓瘤( multiple myeloma，MM) 病人不同发展阶段血同型半胱氨酸( homocysteine，
Hcy) 、β₂ 微球蛋白( β2 －microglobulin，β₂－MG) 及血沉( erythrocyte sedimentation rate，ESR) 水平，以探讨这些因子
在MM 的诊断、治疗及预后判断中的临床意义。方法: 选择MM 病人30 例，正常对照组20 例，测定其血Hcy、β₂－MG
及ESR 水平对结果比较分析，并对MM 病人进行治疗前、后不同阶段进行动态检测。结果: ( 1) AL 组初诊
时血Hcy、β₂ －MG 及ESR 均明显升高，与正常对照组比较有显著性差异( P＜0． 05、P＜0． 05 及P＜0． 01) ; ( 2) 初诊
时MM 病人血浆Hcy、β₂ －MG 及ESR 水平在不同分期之间差异有统计学意义( P＜0． 05 及P＜0． 01) ; ( 3) 经过4
个疗程的治疗后，达到完全缓解［包括完全缓解( CR) 和非常好的部分缓解( VGPR) ］时，血Hcy、β₂ －MG 及ESR
基本恢复正常，与正常对照组比较无显著差异( P＞0． 05) ; ( 4) 经过4 个疗程的治疗后，未达到缓解［包括部分缓
解( PR) 、疾病稳定( SD) 、病情进展( PD) 和完全缓解后复发］时，上述因子与治疗前比较差异无统计学意义( P
＞0． 05) ; ( 5) 相关性分析显示，MM 病人组血Hcy 水平与β₂－MG 及ESR 均为正相关［( r = 0． 71，P＜0． 01) 和( r
= 0． 45，P＜0． 05) ］。结论: 动态监测MM 病人血Hcy、β₂ －MG 及ESR 水平，可作为MM 病情进展、疗效过程及预
后判断的重要参考指标。

Objective: To measure the levels of blood homocysteine、β₂－microglobulin and erythrocyte
sedimentation rate in different phrases of patients with multiple myeloma，and to explore their significance
in the diagnosis and clinical therapy of multiple myeloma． Methods: The β₂－MG、ESR and
Hcy of 30 multiple myeloma patients and 20 health adult were detected， the results were analyzed in
different phrases． Results: ( 1) Compared with normal control group，blood levels of β₂ －MG、ESR and
Hcy were elevated before treatment in multiple myeloma patients( P＜0． 05、P＜0． 05 and P＜0． 01) ．
( 2) The factors of patients with MM at different stages were statistially significant ( P ＜0． 05 and P
＜0． 01) ． ( 3) Compared with normal control group， the β₂ －MG、ESR and Hcy had no difference in
multiple myeloma after complete remission( CR) ( P＞0． 05) ． ( 4) Compared with MM patients before
treatment，β₂ －MG、ESR and Hcy had also no difference in multiple myeloma after non －remission
( NR) ( P＞0． 05) ． ( 5) There was positive correlation between Hcy and β₂－MG、ESR in multiple myeloma
［( r = 0． 71，P＜0． 01) and( r = 0． 45，P＜0． 05) ］． Conclusion: Therefore，monitoring in different
prase the content of blood β₂－MG、ESR and Hcy in multiple myeloma provided the evidence in theory
for early diagnosis prevention and cure of multiple myeloma in clinic．

R738． 1