多发性骨髓瘤肾损害26例分析及应用血液透析疗效评估  

Clinical features of 26 multiple myeloma with renal damage and efficacy evaluation of hemodialysis

作　　者：吴凡[1] 朱玉楠[2] 孙静[2] 杨静[2] 朱趁红[2] 焦雪丽[2] 董秀娟[2] 赵晓武[2] 葛永超[3] 

机构地区：[1]郑州市第三人民医院血液净化科,郑州450000 [2]郑州市第三人民医院血液科 [3]郑州市第三人民医院泌尿外科

出　　处：《医药论坛杂志》2016年第7期17-19,共3页Journal of Medical Forum

基　　金：郑州市科技局基金资助项目(20110824)

摘　　要：目的探讨多发性骨髓瘤（MM）肾损害的临床特征及应用血液透析治疗的效果评估。方法回顾性分析郑州市第三人民医院1998年1月至2015年2月收治的26例以肾损害为首发症状的MM患者临床资料及评估应用血液透析后患者各项生理指标的变化。结果IgG、IgA、IgM、不分泌型分别占65．4％、19．2％、7．7％、7．7％，中位发病年龄63岁。26例患者共透析59次，平均2次，经透析治疗加化疗后一般情况改善，26例患者均于1—2个疗程化疗后脱离血液透析，血清肌酐（SCr）水平可稳定于正常或正常高限。结论以肾损害为首发症状的MM中，以IgG型最常见。早期应用血液透析治疗有助于肾功能恢复，有硼替佐米参与的联合化疗对此类患者疗效满意。Objective To explore the clinical features of muhiple myeloma （MM） with renal damage and assess the ef- ficacy of hemodialysis. Methods The clinical data of 26 cases of diagnosed MM patients gathered in the Third people＇ s hospital of Zhengzhou from Jan. 1998 to Feb. 2015 were retrospectively analyzed. Results The proportions of each kind of MM including IgG, IgA, IgM and nonsecretary MM were 65. 4% , 19. 2%, 7.7% and 7. 7% , respectively. The median age of onset was 63 years. 26 cases received a total 59 times hemodialysis with the average twice per patient. Af- ter dialysis treatment and chemotherapy ,the general situation of the patients were improved. 26 patients departed hemo- dialysis receiving 1 to 2 cycles of chemotherapy and serum creatinine （SCr） levels can be stable at normal or high nor- mal. Conclusion IgG is the most common type in MM with renal damage. The treatment of hemodialysis and chemo- therapy at the early stage could contribute to the recovery of renal function, and bortezomib combined with chemotherapy could obtain satisfactory results.

关 键 词：多发性骨髓瘤 肾损害 血液透析 

分 类 号：R733.3[医药卫生—肿瘤]