432例多发性骨髓瘤临床分析  

THT CLINICAL AND LABORATORY FEATURES OF 432 PATIENTS WITH MULTIPLE MYELOMA

作　　者：麦玉洁[1] 邱录贵[1] 李睿[1] 靳风艳[1] 白洁[1] 万长春[1] 王建祥[1] 季林祥[1] 肖志坚[1] 钱林生[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院血5科,天津300020

出　　处：《白血病．淋巴瘤》2004年第4期198-201,共4页Journal of Leukemia & Lymphoma

基　　金：天津市医学公关基金课题(013111111)

摘　　要：目的：探讨中国多发性骨髓瘤(Mm)患者的临床特点。方法：回顾性分析中国医学科学院血研所1980年1月一2002年12月收治的432例MM患者的临床资料。结果：中位发病年龄s7岁。以男性为主。乏力与骨痛是初诊时最常见的主诉(分剐占60．9％和54．9％)，81％患者有贫血(Hb≤100g／L)，40％患者处于Durie分期Ⅲa期，骨髓中瘤细胞比例中位值0．38(0．005～0．970)。高钙血症、高尿酸血症及肾功能不全的比例分别为9．1％、39．4％和21．1％。分型以IgG型为主(48．1％)。72．1％患者B2．MG升高(>3mg／L)，多数患者伴有TNF、IL．6或IL．2水平升高。70例中有4例检测到13号染色体异常。80．8％患者骨骼有x线异常改变。中位生存期为27月。结论：中国MM患者与欧美国家相比。发病年龄偏低；大多数就诊时已处于Durie分期Ⅲ期；生存期较欧美国家短。Objective: To analyse the presenting features and laboratory features of the patients with multiple myeloma(MM) in our country. Methods: The records of 432 patients with MM in our hospital between January 1980 and December 2002 were retrospectively reviewed. Result: Of the 432 study patients, the median age were 57,male predominant. The most common presenting symptoms at the current study were fatigue(60.9 %) and bone pain(54.9 %). Anemia was present initially in 81 % patients and 40 % of the patients are diagnosed on stage III according to Durie- Samon. The median value of plasma cells in bone marrow was 0.383. Hypercalcemia was seen in 9.1 %, and serum creatinine level≥ 176.8 μmol/L was 21.1 %. The β2- microglobulin level was increased in 72.1 %. IgG was the commonest type(48.1 %) followed by IgA(21.8 %) and light chain(20.5 %). Conventional radiographs showed an abnormality in 80.5 %. The median duration of overall survival was 27 months. Conclusion: Compared with those in American or in Europe, the patients with MM in our country are relatively younger, the β2- microglobulin level is higher and the median duration of overall survival is shorter.

关 键 词：多发性骨髓瘤 临床 分析 

分 类 号：R733.3[医药卫生—肿瘤]