1例血清球蛋白升高对多发性骨髓瘤的早期预警分析  

Early warning analysis of a case of multiple myeloma with elevated serum globulin

作　　者：张黎明 刘道利 李秋明 周伟青 Zhang Liming;Liu Daoli;Li Qiuming;Zhou Weiqing(Clinical Laboratory,Traditional Chinese Medicine Hospital Affiliated to Guangzhou Medical University,Guangzhou 510400,Guangdong,China)

机构地区：[1]广州医科大学附属中医医院检验科,广东广州510400

出　　处：《实用检验医师杂志》2020年第4期254-256,共3页Chinese Journal of Clinical Pathologist

摘　　要：目的报告1例球蛋白(Glb)升高多发性骨髓瘤(MM)患者的诊断过程。方法分析2020年4月22日广州医科大学附属中医医院收治1例Glb升高MM患者的临床资料。该患者入院后进行生化肝功能检测、免疫球蛋白(Ig)电泳检测、骨髓和外周血涂片检查以及影像学检查,分析各项检查结果。结果患者为71岁男性,生化检测显示Glb异常升高;血清IgG电泳结果显示白蛋白(Alb)、α2蛋白、β蛋白、Alb/Glb比值(A/G)下降;骨髓和外周血涂片检查显示,骨髓有核细胞增生活跃,成熟红细胞呈缗钱状排列,血小板呈簇状分布;影像学检查显示,颅盖骨多个小圆形,边缘清楚如凿孔样骨质破坏,可疑腰椎骨质小破坏,左股骨中下段骨髓腔内高密度影性质待定。该患者最终确诊为MM。结论当血清Glb异常升高时,要警惕MM的可能性,可以通过实验室检查分析Glb的性质,为临床诊断提供指导。Objective To report the diagnositic process of one case of multiple myeloma(MM)with elevated globulin(Glb).Methods The clinical data of one MM patient with elevated Glb admitted to Traditional Chinese Medincine Hospital Affiliated to Guangzhou Medical University on April 22,2020 were analyzed.After admission,the patient underwent biochemical liver function test,immunoglobulin(Ig)electrophoresis detection,bone marrow and peripheral blood smear,and the results were analyzed.Results The patient was a 71-year-old male,the biochemical examination showed abnormal increase of Glb.The results of serum IgG electrophoresis showed that albumin(Alb),α2 protein,βprotein and Alb/Glb ratio(A/G)decreased.Bone marrow and peripheral blood smears showed that nucleated cells proliferated actively,mature red blood cells were arranged in the shape of crisscross,and platelets were distributed in clusters.Imaging examination showed that the cranial cap bone was multiple small round,with clear edges and perforation like bone destruction,suspected small bone destruction of lumbar spine,and the nature of high-density image in bone marrow cavity of the middle and lower segment of left femur was undetermined.At last the patient was diagnosed as MM.Conclusions When the serum Glb is abnormally high,we should be alert to the possibility of MM.We can analyze the properties of Glb through laboratory examination to provide guidence for the clinical direction.

关 键 词：异常球蛋白 M蛋白 本周蛋白 电泳 多发性骨髓瘤 

分 类 号：R733.3[医药卫生—肿瘤] R446.1[医药卫生—临床医学]