多发性骨髓瘤肾病并发慢性肾功能衰竭行连续性血液滤过的治疗观察  

Therapeutic effect of continuous veno-venous hemofiltration in chronic renal failure patients secondary to multiple myeloma

作　　者：咸伟[1] 申捷[1] 王素娟[1] 祁云香[1] 罗志尚[1] 

机构地区：[1]新乡医学院第三附属医院肾内科,河南新乡453003

出　　处：《中国医药科学》2013年第17期69-71,共3页China Medicine And Pharmacy

摘　　要：目的通过系统观察连续性静静脉血液透析滤过(CVVH)和(或)联合化疗在多发性骨髓瘤肾病合并慢性肾功能衰竭治疗中的反应,进行多发性骨髓瘤肾病(MMN)治疗前后相关临床及免疫炎症指标变化情况的比较,结合相应的实验室临床指标监测,寻求疗效更好、不良反应更少的治疗方法。方法 40例患者随机分为联合化疗组(B组)20例与连续性血液滤过透析后进行联合化疗组(A组)20例,比较两组患者的疗效。结果 A组在2个疗程后总有效率、肾功能恢复率、血肌酐(SCr)、轻链蛋白、血钙和血尿酸均显著地优于B组(P<0.05);但是两组患者的血清球蛋白差异无统计学意义(P>0.05)。结论连续性静静脉血液透析滤过和联合化疗在多发性骨髓瘤肾病合并慢性肾功能衰竭治疗中有优势,2个疗程可明显观察到临床症状缓解,临床活动指标可有效改善。Objective To evaluate the therapeutic effect of continuous veno-venous hemofiltration （CVVH） alone. Combined with chemotherapy in chronic renal failure patients secondary to multiple myeloma; Assess the changes of clinical signs, immunological and inflammatory index before and after CVVH in the same group patients; to find a more appropriate treatment protocol for these patients. Methods Forty chronic renal failure patients secondary to multiple myeloma were randomized into two groups including 20 patients each. Group A was given CVVH combined with chemotherapy and group B was given chemotherapy alone. The therapeutic effect was compared between two groups. Results After 2 courses, the overall effective rate, renal function recovery rate, serum creatinine （SCr）, light chain protein, blood calcium, and blood uric acid in A group were significantly higher than those in the B group （P 〈 0.05）. However, there was no significant in seroglobulin between two groups （P 〉 0.05）. Conclusion The treatment protocol of CVVH combined with chemotherapy showed a beneficial therapeutic effect on chronic renal failure patients secondary to multiple myeloma compared with treatment protocol of chemotherapy alone. After two courses of treatment, improvements of patients could be observed.

关 键 词：连续性静脉血液透析滤过 多发性骨髓瘤肾病 慢性肾功能衰竭 

分 类 号：R733.3[医药卫生—肿瘤]