中文摘要：

目的 研究多发性骨髓瘤（MM）患者血清Dickkopf^-1（DKK-1）、可溶性核因子KB配体受体激活剂（sRANKL）、护骨素（OPG）和骨代谢因子[碱性磷酸酶（ALP）、抗洒石酸酸性磷酸酶（TRACP-5b）]水平及其与MM分期、溶骨性病变的关系，探讨骨代谢及调节因子DKK-l和sRANKI．在MM骨病中的临床意义。方法 采用双抗体夹心ELISA检测30例初诊MM患者和20例健康人血清DKK-1、sRANKL、OPG、ALP、TRACP-5b等骨代谢因子及调节因子的水平。结果 MM患者血清DKK－1、sRANKL、OPG和TRACP水平均显著高于键康人，分别为42．96μg／L比5．33μg/L，1．83pmol／L比0．79pmol／L，1799．30pmol／L比822．40pmol／L，5．81U／L比0．28U／L，P值均〈0．05。国际分期系统（ISS）分期Ⅲ期患者血清DKK-1水平（46．33μg／1．）和sRANKI．（2．26pmol／L）水平显著高于Ⅰ／Ⅱ期患者（37．91斗g／L和1．19pmol／L，P值均〈0．05）。3处以上与1～3处溶骨病变患耆相比，血清DKK－1、sRANKL和’FRACP－5b水平屁著升高（46．30μg/L比31．98μg/L，2．18pmo1／L比0．69pmol／L，6．02U／L比5．13U／L,P值均〈0．05）：结论 MM患者血清DKK-l、sRANKL、OPG和TRACP-5h水平均显著高于健康人；血清DKK-1、sRANKL水平与MM分期及溶骨病变程度相关。

英文摘要：

Objective To detect serum concentrations of Dickkopf-I （DKK-I） and soluble receptor activator of nuclear factor-KB ligand （sRANKL） in patients with multiple myeloma （MM） and to investigate its clinical significance. Methods Serum DKK-1, sRANKL, osteoporotegerin（OPG） and tartrate-resistant acid phosphatase 5b （TRACP-5b） levels were quantified in 30 newly diagnosed MM patients and 20 heahhy control subjects by using sandwich ELISA. Results The serum DKK-I, sRANKL, OPG and TRACP-5b levels were significantly higher than those in the healthy controls （42.96 p,g/L vs 5.33 p,g/L, 1.83 pmol/L vs 0. 79 pmol/L, 1799, 30 pmol/L vs 822.40 pmol/L, 5.81 U/L vs 0. 28 U/L, respectively; all P 〈 0.05）. Serum levels of DKK-I were positively correlated with sRANKL, and TRACP-5b, respectively. Serum concentrations of DKK-1 and sRANKL were significantly elevated in stageⅢ vs stages Ⅰ and Ⅱ according to International Staging System （ISS） （46. 33 txg/L vs 37.91 p,g/L, 2.26 pmol/L vs 1.19 pmol/L, respectively, all P 〈 0. 05 ） . Serum concentrations of DKK-I , sRANKI, and TRACP-5b were significantly higher in patients with more than 3 lytic bone lesions than those with only 1-3 lytic bone lesions （46. 30 p,g/L vs 31.98 p,g/L, 2. 18 pmol/L vs 0. 69 pmol/L, 6. 02 U/L vs 5. 13 U/I,, all P 〈 0. 05）. Conclusions MM patients have increased serum DKK-I, sRANKL, OPG and TRACP-5b levels as compared with the heahhy controls. Serum concentrations of DKK-1 and sRANKL have close relationship with MM stage and lyric bone disease.