多发性骨髓瘤误诊与实验室检查的关系  

The relation between misdiagnosis of mutiple myeloma and laboratory assay

作　　者：陈琦[1] 龚芳泽[1] 任明强[1] 

机构地区：[1]遵义医学院附院血液科,563003

出　　处：《贵州医药》2002年第1期25-26,共2页Guizhou Medical Journal

摘　　要：目的探讨多发性骨髓瘤 (MM)误诊与实验检查的关系。方法MM及正常人血清分别以原血清及 1∶4稀释后用速率散射比浊法测IgG值 ;MM及正常人尿液分成 3份测本周蛋白 ,A管 ,尿用pH4 9醋酸缓冲液酸化 ,置 5 6℃水浴 15min ,B管不加缓冲液 ;C管置水浴 7～ 8min。结果 2 0例MM未稀释血清IgG16 .8± 6 94 (g/L) ;1∶4稀释血清IgG35 .89± 11 88(g/L) ,P <0 0 1;A组尿本周蛋白的阳性率 5 1 5 % ,B组及C组分别为 2 1 2 %及 2 4 2 % ,P <0 0 5。结论MM血清未稀释形成后带现象及尿本周蛋白定性操作不规范是导致MM误诊的重要原因。Objective To investigate the relation between misdiagnosis of MM and laboratory assay. Methods Level of IgG of MM patients and normal control was detected by rate nephelometers; Urine of MM patients and normal control was divided into three parts: tube A urine acidify with pH 4.9 acetate buffer in 56℃ water-bath for 15min, tube B, urine without acidify, tube C, in water-bath for 7~8min. Results The level of IgG in undiluted serum of MM was 16.8±6.94(g/L) and 1:4 diluted serum was 35.89±11.88(g/L) respectively ( P <0.01). Bances Jones proteinuria positive rate of tube A.B and C were 51.5%, 21.2% and 24.2%,respectively. Conclusion The undiluted serum of MM patient containing the highest concentration form postzone phenomenon and mistaken step to analyse Bances Jones proteinuria were important causes to induce misdiagnosis of MM.

关 键 词：多发性骨髓瘤 误诊 实验室检查 诊断 

分 类 号：R733.3[医药卫生—肿瘤] R730.43[医药卫生—临床医学]