多发性骨髓瘤肾损害的临床分析  

Clinical Analysis of Multiple Myeloma with Renal Impairment

作　　者：周志刚[1] 吴文忠[1] 许欢[1] 李皎[1] 

机构地区：[1]宜兴市人民医院血液科,江苏宜兴214200

出　　处：《系统医学》2016年第11期104-107,共4页Systems Medicine

摘　　要：目的分析多发性骨髓癌肾损害临床特征和有关因素。方法选择该院在2015年1月—2016年1月间收治的因多发性骨髓瘤就诊的67例患者,回顾性分析临床特征和实验室检查结果,首先根据MM诊断标准确定患者的病情,然后对患者采取相应的检查方法,如骨髓穿刺、X线和活检检查,明确患者病理,针对患者的具体情况采取相应的治疗措施,观察并评估患者的肾损害表现及相应的影响因素。结果 67例中,肾损害42例,比例62.69%。甲组42例中,8例B2微球蛋白<5.5 mg/L(19.05%);6例尿酸≤420μmol/L(14.29%);11例血钙≤2.67 mmol/L(26.19%),37例血红蛋白<90 g/L(88.10%),7例轻链蛋白阴性(16.67%)。乙组25例中,12例B2微球蛋白<5.5 mg/L(48%),10例尿酸≤420μmol/L(40%),18例血钙≤2.67 mmol/L(72%),8例血红蛋白<90(32%),17例轻链蛋白阴性(68%),甲组B2微球蛋白、血钙、尿酸和尿轻链蛋白较乙组高,差异有统计学意义(P<0.05)。甲组血红蛋白较乙组低,差异有统计学意义(P<0.05)。结论多发性骨髓瘤肾损害对于患者的影响较大,需要及时确诊并给予患者对症治疗,临床研究显示与B2微球蛋白、血钙、尿酸和尿轻链蛋白等有密切关系,有一定临床特征,需引起重视,确保及时确诊患者病情,并给予对症治疗,将对患者的影响降到最低。Objective To analyze multiple myeloma with renal impairment Clinical characteristics and related factors.Methods A hospital in January 2015 to January 2016 were treated due to multiple myeloma treatment of 67 patients were retrospectively analyzed clinical features and laboratory findings, first determine the patient＇s condition based on MM diagnostic criteria, then take the appropriate screening method for patients, such as bone marrow biopsy, X-ray and biopsy examination, patient pathology, to take appropriate measures for the treatment of patients with specific conditions, to observe and assess the performance of patients with renal impairment and related factors. Results 67 cases of kidney damage in 42 cases, the proportion of 62.69%. Group A 42 cases, eight cases of B2-microglobulin 5.5 mg/L（19.05%）; 6 cases of Li uric acid ≤420 μmol/L（14.29%）; 11 cases of calcium ≤2.67 mmol/L（26.19%）, 37 cases of hemoglobin 90 g/L（88.10%）, 7 patients with mild-chain protein negative（16.67%）. Group B 25 cases, 12 cases of B2-microglobulin 5.5 mg/L（48%）, 10 cases of uric acid ≤420 μmol/L（40%）, 18 cases of calcium ≤2.67 mmol/L（72%）,8 cases of hemoglobin 90 g/L（32%）, 17 cases of light chain protein negative（68%）, Group B2 microglobulin, calcium,uric acid and urine light chain protein higher than the group B, there was significant difference（P〈0.05）, possessed sta-tistical significance. Group A Group B hemoglobin relatively low, there is a significant difference（P〈0.05）, possessed statistical significance. Conclusion Multiple myeloma patients with renal impairment impact is large, the need for timely diagnosis and symptomatic treatment administered to the patient, clinical studies and B2 microglobulin, calcium, uric acid and urinary light chain proteins are closely related, there is some clinical characteristics, need to pay attention to ensure the timely diagnosis of the patient＇s condition, and given symptomatic treatment, will affect the patient＇s minimum.

关 键 词：多发性骨髓瘤 肾损害 特征 实验室检查 

分 类 号：R738.1[医药卫生—肿瘤]