以高钙血症为突出表现的非霍奇金淋巴瘤的临床特征(附7例报告)  

Clinical characteristics of the non-Hodgkin's lymphoma with the first manifestation of complication of hypercalcemia:a report of 7cases

作　　者：廖丽昇[1,2] 郑志海[1,2] 谢颖[1,2] 陈碧云[1,2] 陈为民[1,2] 

机构地区：[1]福建省立医院 [2]福建医科大学省立临床学院血液科,福州350001

出　　处：《临床血液学杂志》2014年第4期583-585,共3页Journal of Clinical Hematology

摘　　要：目的：探讨非霍奇金淋巴瘤（NHL）并发高钙血症患者的发病机制及临床特点。方法：回顾性分析7例NHL并发高钙血症患者的临床表现、诊治及转归。结果：7例患者中男3例,女4例;初诊5例,复发进展2例;伴骨髓侵犯6例,其中4例已达白血病期;血钙浓度3.50-5.02mmol/L,乳酸脱氢酶266-9 261mmol/L,血β2微球蛋白3.86-7.71mg/L,Ki67（增殖细胞核抗原）70%-95%,甲状旁腺激素降低5例,多发骨破坏1例,骨质疏松1例。所有患者均给予降钙治疗,1例顽固性高钙血症在加用糖皮质激素后血钙降至正常,1例出现急性肾功能不全行血液透析。5例初诊患者给以原发病的治疗,未再出现高钙血症,其中1例患者共完成8个疗程化疗,但出现病情进展,生存期仅9个月。结论：NHL并发高钙血症常见于中高度NHL,临床分期常较晚期,常伴有血清乳酸脱氢酶升高、肿瘤细胞高负荷及高增殖活性,生存期短,预后不良。Objective：To investigate the pathogenesis and clinical characteristics of the non-Hodgkin＇s lymphoma（NHL）patients with complication of hypercalcemia.Method：The clinical manifestations,treatments and outcomes of 7NHL patients with complication of hypercalcemia were analyzed retrospectively.Result：Of all 7patients,3males and 4females,5newly diagnosed and 2relapsed or progressed,6patients were with bone marrow involvement,including 4patients reach of leukemia phase of lymphoma.Of all the patients,serum calcium ranged from 3.50to 5.02mmol/L,LDH 266to 9 261mmol/L,β2-MG 3.86to 7.71mg/L,Ki67（pcna）70%to 95%.There were 5cases of parathyroid hormone level decreased,one case of multiple bone destruction,and one case of osteoporosis.All the patients were accepted calcitonin treatments,one case of intractable hypercalcemia normalized the serum calcium following administration of glucocorticoid,and another case developed acute renal insufficiency receiving hemodialysis.Five cases of newly diagnosed patients were given the treatment of lymphoma and hypercalcemia did not recur,but one case survived only 9months after totally eight cycles of chemotherapy because of the disease progression.Conclusion：NHL complicated by hypercalcemia is common in intermediate or high risk NHL,often in late stage and often accompanied by elevated serum LDH,high-tumor-burden,high cell proliferation activity,which has short survival and poor prognosis.

关 键 词：高钙血症 非霍奇金淋巴瘤 发病机制 预后 

分 类 号：R733.4[医药卫生—肿瘤]