以消化道出血为首要表现的多发性骨髓瘤临床分析  

Clinical analysis of multiple myeloma with hemorrhage of digestive tract as initial manifestations

作　　者：李红梅[1] 王拥军[1] 

机构地区：[1]首都医科大学附属北京友谊医院消化内科,北京100050

出　　处：《临床和实验医学杂志》2016年第22期2265-2267,共3页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金资助项目(编号:7152043)

摘　　要：目的 探讨以消化道出血为首要表现的多发性骨髓瘤的临床特征。方法 以消化道出血为首要表现的多发性骨髓瘤患者为研究对象,分析其临床表现、实验室检查、内镜检查的特点。结果 6例以消化道出血为首要表现的多发性骨髓瘤患者,男性5例,女性1例,年龄33-70岁。消化道出血表现为便血1例,脓血便2例,黑便3例,其中2例伴呕血。内镜下表现胃溃疡2例,胃毛细血管扩张1例,结肠溃疡2例,小肠溃疡1例。结论 多发性骨髓瘤临床表现多样,以消化道出血为首要表现的多发性骨髓瘤在临床上少见。对伴有免疫球蛋白升高、贫血、蛋白尿等多系统受累的患者应注意完善骨髓瘤方面的检查,及时诊断治疗。Objective To explore the clinical features of multiple myeloma with hemorrhage of digestive tract as initial manifestations. Methods 6 patients of multiple myeloma with hemorrhage of digestive tract as initial manifestations were analyzed, including its clinical manifestations, laboratory tests, endoscopic characteristics. Results 6 patients of multiple myeloma with hemorrhage of digestive tract as initial manifestations ,including 5 men and 1 women, aged from 33 to 70 years old. Digestive tract hemorrhage showed hematochezia in 1 cases, pus and blood stool in 2 cases, melena in 3 cases （ including 2 cases with hematemesis）. Endoscopic manifestations showed gastric ulcer in 2 cases, gastric dilation in 1 case, colonic ulcer in 2 cases, small intestinal ulcer in 1 case. Conclusion The clinical features of multiple myeloma are varied. MM with hemorrhage of digestive tract as initial manifestations is rare in clinical work. The patients with the increased immune globulin, anemia, proteinuria and other systemic involvement should be payed attention, in order to improve the diagnosis and treatment of myeloma, make correct diagnosis timely and guild the treatment.

关 键 词：多发性骨髓瘤 消化道出血 临床特征 

分 类 号：R733.3[医药卫生—肿瘤]