目的测定不同临床阶段多发性骨髓瘤(MM)患者骨髓中血管新生因子的水平,分析其与疾病-临床分期之间的关系。方法选取66例MM(其中新诊断1例,难治/复发1例)和7例意义未明的单克隆丙种球蛋白病(MGUS)为研究对象。所有研究对象均进行骨髓穿刺,采骨髓5ml,以肝素抗凝,分离血浆。对于新诊断的MM患者,经过6个疗程的积极治疗后,再次进行骨髓穿刺。应用ELISA法测定骨髓中血管新生因子(IL-6、VEGF、bFGF、MMP-2、MMP-9)的浓度。结果新诊断MM患者与复发/难治患者的骨髓血管新生因子水平显著高于缓解患者与MGus:MGUs患者除MMP一9低于缓解患者外,其余细胞因子水平与缓解患者无明显差异。新诊断MM患者经治疗后,有效者骨髓血管新生因子水平下降。结论促血管新生因子促进血管新生,在多发性骨髓瘤的发病机制中发挥重要作用,抗血管新生或拮抗血管新生因子可以有效治疗多发性骨髓瘤。 Objective To determine the levels of angiogenic factors in the bone marrow of patients with multiple myeloma (MM) at different clinical stages and analyze their relationship with disease-clinical stage. Methods Sixty-six MM patients (including 1 newly diagnosed, refractory / relapsed) and 7 unrelated monoclonal gammopathy (MGUS) were enrolled in this study. All subjects were bone marrow puncture, mining bone marrow 5ml, with heparin anticoagulant, plasma separation. For newly diagnosed MM patients, after 6 courses of active treatment, bone marrow puncture is performed again. The concentration of angiogenic factors (IL-6, VEGF, bFGF, MMP-2, MMP-9) in bone marrow was measured by ELISA. Results The levels of bone marrow angiogenic factor in newly diagnosed MM patients and relapsed / refractory patients were significantly higher than that in remission patients and MGus: MGUs patients except those with MMP-9 were lower than those in remission patients. There was no significant difference between the other cytokines and remission patients. Newly diagnosed MM patients after treatment, the effective level of bone marrow angiogenic factor decreased. Conclusions Angiopoietin promotes angiogenesis and plays an important role in the pathogenesis of multiple myeloma. Antiangiogenesis or antagonism of angiogenic factors can effectively treat multiple myeloma.