腰椎型多发性骨髓瘤骨病的临床特点分析  

Clinical characteristics of lumbar type of multiple myeloma bone disease

作　　者：张旭晗 王丽 程雅馨 汪安友 杨会志 朱薇波 蔡晓燕 朱小玉 刘欣[1] ZHANG Xu-han;WANG Li;CHENG Ya-xin;WANG An-you;YANG Hui-zhi;ZHU Wei-bo;CAI Xiao-yan;ZHU Xiao-yu;LIU Xin(Department of Hematology,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)血液科,安徽合肥230001 [2]中国科学技术大学附属第一医院(安徽省立医院)康复医学科,安徽合肥230001

出　　处：《颈腰痛杂志》2020年第4期395-399,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：国家自然科学基金面上项目(编号:81670165);安徽省国际合作项目(编号:1804b06020352);中科大创新团队项目(编号:WK9110000001,WK9110000060)。

摘　　要：目的探讨腰椎型多发性骨髓瘤骨病(multiple myeloma bone disesase,MMBD)的临床特点以及在新药时代的疗效。方法回顾性分析本院血液科自2015年11月-2018年11月收治的腰椎型MMBD患者94例,按多发性骨髓瘤分型分组比较其临床特点、实验室指标及疗效。结果94例腰椎型MMBD的原发病分型为:IgA型20例,IgG型52例,IgD型4例,轻链型18例,其中IgG型较为常见,而IgD型较为少见,其类型分布与非MMBD患者类似。腰椎型MMBD的贫血发生率为85.1%,肾功能损害发生率为50%,高钙血症发生率为34%,疾病分型对于三者无统计学意义(P>0.05),但IgA型合并贫血时的症状最为显著。使用蛋白酶体抑制剂患者的总生存率高于不使用组(P<0.001);使用二磷酸盐对MMBD患者的疗效无明显助益。结论蛋白酶体抑制剂可增加腰椎型MMBD患者的长期生存率,疾病分型不影响腰椎型MMBD的疗效评价。Objective To analyze the clinical characteristics of lumber type of multiple myeloma bone disease(MMBD).Methods The clinical data of 94 patients with lumber type of MMBD in our hospital from November 2015 to November 2018 were retrospectively analyzed.According to the classification of multiple myeloma,the clinical characteristics,laboratory indicators and efficacy were compared.Results The types of 94 patients with lumber type of MMBD were similar with non-lumber type,including 20 patients with IgA type,52 patients with IgG type,4 patients with IgD type and 18 patients with light chain type.The incidence rate of anemia was 85.1%,the incidence rate of renal function injury was 50%,and the incidence rate of hypercalcemia was 34%.The types of disease had no influence on the complications such as anemia,renal function injury and hypercalcemia(P>0.05),but the symptoms of IgA type with anemia were the most significant.The overall survival of MMBD patients who received proteinase inhibitor therapy was higher than those without proteinase inhibitor therapy(P<0.001).The outcomes of biophosphonates treatment were similar between the types of lumber type MMBD.Conclusion The type of disease does not affect the clinical characteristics of lumbar type MMBD,and proteinase inhibitor is benefited for overall survival of lumbar type MMBD.

关 键 词：腰椎型 多发性骨髓瘤 骨病 临床特点 

分 类 号：R733.3[医药卫生—肿瘤]