多发性骨髓瘤患者骨髓单个核细胞Treg、Th17和血清IL-6、IL-10与临床分期以及治疗效果的关系分析

摘要 目的：探讨多发性骨髓瘤（MM）患者骨髓单个核细胞调节性T细胞（Treg）、辅助性T细胞（Th17）和血清白细胞介素-6（IL-6）、白细胞介素-10（IL-10）与临床分期以及治疗效果的关系。方法：选择2016年3月至2020年12月河北医科大学第一医院收治的MM患者60例为研究对象，检测并对比不同Durie-Salmon分期患者的骨髓单个核细胞Treg、Th17、Treg/Th17及血清IL-6、IL-10水平；患者入院后均给予常规治疗，根据疗效分为有效组和无效组，比较两组治疗前后骨髓单个核细胞Treg、Th17、Treg/Th17及血清IL-6、IL-10水平；分析Treg、Th17、Treg/Th17及血清IL-6、IL-10与MM患者Durie-Salmon分期、治疗效果的相关性。结果：MM患者骨髓单个核细胞Treg、Treg/Th17及血清IL-6、IL-10水平III期组高于II期组，II期组高于I期组（P＜0.05）。有效组治疗后骨髓单个核细胞Treg、Treg/Th17水平及血清IL-6、IL-10水平较治疗前明显降低（P＜0.05）；治疗后，骨髓单个核细胞Treg、Treg/Th17及血清IL-6、IL-10水平无效组高于有效组（P＜0.05）。骨髓单个核细胞Treg、Treg/Th17及血清IL-6、IL-10水平与MM患者Durie-Salmon分期呈正相关，与治疗效果呈负相关（P＜0.05）；骨髓单个核细胞Th17水平与MM患者的Durie-Salmon分期、治疗效果无明显的相关性（P＞0.05）。结论：骨髓单个核细胞Treg、Treg/Th17水平及血清IL-6、IL-10水平与MM患者肿瘤临床分期、治疗效果密切相关，检测其水平可对MM的临床治疗及预后起到一定评估作用。

Relationship between Bone Marrow Mononuclear Cell Treg, Th17, Serum IL-6 and IL-10 and Clinical Stage and Therapeutic Effect in Patients with Multiple Myeloma

ABSTRACT Objective: To investigate the relationship between bone marrow mononuclear cell regulatory T cell (Treg), helper T cell (Th17), serum interleukin-6 (IL-6) and interleukin-10 (IL-10) and clinical stage and therapeutic effect in patients with multiple myeloma (MM). Methods: 60 patients with MM who were treated in the first hospital of Hebei Medical University from March 2016 to December 2020 were selected as the research object. The levels of bone marrow mononuclear cells Treg, Th17, Treg/Th17 and serum IL-6 and IL-10 in patients with different Durie salmon stages were detected and compared. All patients were given routine treatment after admission. According to the curative effect, they were divided into effective group and ineffective group. The levels of Treg, Th17, Treg/Th17 and serum IL-6 and IL-10 of bone marrow mononuclear cells in the two groups were compared before and after treatment. To analyze the correlation between Treg, Th17, Treg/Th17, serum IL-6 and IL-10 and Durie salmon stage and treatment effect of MM patients. Results: The levels of Treg, Treg/Th17 and serum IL-6 and IL-10 in phase III group were higher than those in phase II group, and those in phase II group were higher than those in phase I group (P<0.05). The levels of Treg and Treg/Th17 in bone marrow mononuclear cells and serum IL-6 and IL-10 in the effective group were significantly lower than those before treatment (P<0.05). After treatment, the levels of Treg, Treg/Th17 of bone marrow mononuclear cells and serum IL-6 and IL-10 in the ineffective group were higher than those in the effective group (P<0.05). The levels of Treg, Treg/Th17 and serum IL-6 and IL-10 in bone marrow mononuclear cells were positively correlated with Durie salmon stage and negatively correlated with treatment effect (P<0.05). There was no significant correlation between Th17 level of bone marrow mononuclear cells and Durie salmon stage and therapeutic effect in MM patients (P>0.05). Conclusion: The levels of Treg and Treg/Th17 in bone marrow mononuclear cells and serum IL-6 and IL-10 are closely related to the clinical stage and treatment effect of mm. Detecting their levels can play a certain role in evaluating the clinical treatment and prognosis of mm.