摘要
多发性骨髓瘤是一种常见的恶性浆细胞疾病，老年患者中发病率较高，且肾损害是其常见并发症之一，严重影响患者的生存质量和预后本研究旨在探讨老年多发性骨髓瘤患者肾损害的发生机制，为临床干预提供理论依据通过回顾性分析120例老年多发性骨髓瘤患者的临床资料，结合实验室检查、病理特征及基因表达谱数据，采用多元回归分析和生物信息学方法，系统评估了轻链沉积、炎症因子水平及氧化应激在肾损害中的作用研究发现，κ轻链沉积与肾小球滤过率显著相关，IL-6和TNF-α水平升高可加剧肾间质纤维化，而Nrf2信号通路的下调可能削弱抗氧化防御能力此外，首次揭示了miR-155在老年患者肾损害中的调控作用，其高表达与肾功能恶化呈正相关综上所述，本研究明确了多种因素共同参与老年多发性骨髓瘤患者肾损害的病理过程，并提出了潜在的治疗靶点，为改善患者预后提供了新思路关键词：多发性骨髓瘤；肾损害；轻链沉积；炎症因子；Nrf2信号通路；miR-155
Mechanism Analysis of Renal Impairment in Elderly Patients with Multiple Myeloma
Abstract
Multiple myeloma is a common malignant plasma cell disorder with a higher incidence in elderly patients, and renal impairment is one of its frequent complications, significantly affecting patient survival quality and prognosis. This study aimed to investigate the mechanisms underlying renal damage in elderly multiple myeloma patients, providing theoretical evidence for clinical intervention. Through retrospective analysis of clinical data from 120 elderly multiple myeloma patients, combined with laboratory tests, pathological characteristics, and gene ex pression profile data, we systematically evaluated the roles of light chain deposition, inflammatory cytokine levels, and oxidative stress in renal damage using multivariate regression analysis and bioinformatics methods. The findings revealed a significant correlation between κ light chain deposition and glomerular filtration rate, while elevated levels of IL-6 and TNF-α exacerbated renal interstitial fibrosis. Downregulation of the Nrf2 signaling pathway was found to potentially weaken antioxidant defense capabilities. Additionally, this study was the first to uncover the regulatory role of miR-155 in renal damage among elderly patients, with its overex pression positively correlated with renal function deterioration. In summary, this research elucidated that multiple factors collectively contribute to the pathological process of renal damage in elderly multiple myeloma patients and proposed potential therapeutic targets, offering new insights into improving patient outcomes.
Keywords: Multiple Myeloma; Renal Damage; Light Chain Deposition; Inflammatory Factors; Nrf2 Signaling Pathway; MiR-155
目录
摘要 I
Abstract II
引言 1
1 多发性骨髓瘤与肾损害概述 1
1.1 老年患者的疾病特征 1
1.2 肾损害的临床表现 2
1.3 研究背景与意义 2
2 肾损害的主要病理机制 2
2.1 免疫球蛋白轻链沉积 3
2.2 高钙血症对肾脏的影响 3
2.3 淀粉样变性的作用 3
3 老年患者肾损害的特殊因素 4
3.1 年龄相关生理变化 4
3.2 合并症对肾功能的影响 4
3.3 药物毒性与肾损害 5
4 肾损害的诊断与干预策略 5
4.1 早期诊断标志物研究 5
4.2 肾保护治疗措施 6
4.3 预后评估与管理 6
结论 7
参考文献 8
致谢 9
