多发性骨髓瘤化疗期间感染病原菌分布及血清β2M、MLR及PLR的检测价值分析OA

Objective To analyze the distribution of pathogenic bacteria in multiple myeloma(MM)patients with infections during chemotherapy and the predictive value of serum β2-microglobulin(β2M),monocyte-to-lymphocyte ratio(MLR)and platelet-to-lymphocyte ratio(PLR)for infection occurrence.Methods A prospective study was conducted on 96 MM patients undergoing chemotherapy at Zhengzhou Central Hospital affiliated to Zhengzhou University from March 2021 to March 2024.Based on the occurrence of infection during hospitalization for chemotherapy,patients were divided into an infection group(n=42)and a non-infection group(n=54).The distribution of pathogenic bacteria in infected patients was analyzed.General clinical data and levels of β2M,MLR and PLR were compared between the two groups.Pearson correlation analysis was used to assess the correlations between β2M/MLR/PLR levels and inflammatory markers.Univariate analysis and binary logistic regression were employed to identify independent risk factors for infection during chemotherapy.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of β2M,MLR,and PLR levels for infection occurrence.Results A total of 46 strains of pathogenic bacteria were isolated in 42 infected patients,including 12 strains of Gram-positive bacteria(26.09%),27 strains of Gram-negative bacteria(58.69%)and 7 strains of fungi(15.22%).The proportions of patients with International Staging System(ISS)stage Ⅲ disease,renal insufficiency,granulocytopenia,serum albumin<30 g/L,and the level of interleukin-17(IL-17)[50.00%,61.90%,45.24%,57.14%,and(77.68±9.26)pg/mL,respectively]were significantly higher in the infection group than in the non-infection group[25.93%,31.48%,25.93%,31.48%,and(66.45±8.47)pg/mL,respectively,χ2/t=6.648,8.843,3.906,6.358,6.186,P<0.05].Levels of β2M,MLR and PLR were significantly higher in the infection group than those in the non-infection group(P<0.001).Pearson correlation analysis showed positive correlations between β2M,MLR,PLR levels and IL-17(r=0.634,0.520,0.438,respectively,P<0.05),and negative correlations with serum albumin levels(r=-0.551,-0.568,-0.644,respectively,P<0.05).Binary logistic regression analysis identified ISS stage Ⅲ,renal insufficiency,granulocytopenia,decreased serum albumin levels,and elevated levels of β2M,MLR,and PLR as independent risk factors for infection during MM chemotherapy(P<0.05).ROC curve analysis revealed that the areas under the curve(AUC)for predicting infection using β2M,MLR and PLR alone were 0.823,0.809 and 0.816,respectively.The AUC for their combined detection was 0.941,which was significantly higher than that of any single marker(P<0.05).Conclusions Serum levels of β2M,MLR and PLR are significantly elevated in MM patients with infections.The combined detection of these three markers holds potential application value for predicting infections in MM patients.