多发性骨髓瘤患者血液异常分离结果的临床意义  

Clinical significance of abnormal blood separation in multiple myeloma

作　　者：褚娜利 范洪[1] 郭丽[2] 许迪[2] 张华[2] 张靖宇[1] CHU Nali;FAN Hong;GUO Li;XU Di;ZHANG Hua;ZHANG Jingyu(Department of Laboratory Diagnosis,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province,Hebei Province,Cangzhou061001,China;Department of Hematology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province,Hebei Province,Cangzhou061001,China)

机构地区：[1]河北省沧州中西医结合医院实验诊断科,河北沧州061001 [2]河北省沧州中西医结合医院血液科,河北沧州061001

出　　处：《中国医药导报》2020年第34期157-160,共4页China Medical Herald

基　　金：河北省人才工程培养资助项目(A201901110);河北省医学科学研究课题计划项目(20191283);河北省沧州市科学技术研究与发展指导计划项目(172302167)。

摘　　要：目的探讨多发性骨髓瘤(MM)患者血液异常分离结果的临床意义。方法选择河北省沧州中西医结合医院2008年3月—2019年10月收治的282例MM患者(IgG型152例、IgA型92例、IgD型6例、轻链型32例)以及同期200例自身免疫性疾病患者和200名健康体检者为研究对象。采用分离胶真空采血管采集空腹静脉血,离心后观察血液分离结果。根据血液分离结果将其分为对照组和异常组,比较两组检验免疫球蛋白(Ig)、总蛋白(TP)、血红蛋白(Hb)、血细胞比容(Hct)、血小板计数(PLT)、纤维蛋白原(Fig)水平的差异。结果自身免疫病患者、健康体检者及部分MM患者血液分离正常,分3层,自上而下依次为:血清、分离胶、红细胞,血清和红细胞比例适当;血液分离异常者均为MM患者,异常血液分离为4层,自上而下依次为:血清、红细胞、分离胶、红细胞,上层有少量血清,其下红细胞增多,底层有少量红细胞。282例MM患者中血液异常分离有46例(16.31%)。异常分离现象仅见于IgG型(28例)和IgA型(18例),所占比例分别为60.87%和29.13%。异常组TP、Ig水平高于对照组,Hb、Hct水平低于对照组(均P<0.05)。结论MM患者分离胶真空采血管可能存在血液分离异常现象。日常工作中遇到血液分离异常现象时,应及时与临床医师沟通并进一步进行确诊试验。Objective To investigate the abnormal blood separation in multiple myeloma(MM).Methods A total of 282 MM patients(152 cases of IgG type,92 cases of IgA type,6 cases of IgD type and 32 cases of light chain type),200 autoimmune diseases patients and 200 healthy physical examinees were selected from Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province from March 2008 to October 2019.Fasting venous blood was collected by vacuum blood collection with separation gel,and the results of blood separation were observed after centrifugation.The patients were divided into the control group and the abnormal group according to the blood separation results,and the differences of immunoglobulin(Ig),total protein(TP),hemoglobin(Hb),hematopoietic volume(Hct),platelet count(PLT),and fibrinogen(Fig)levels were compared between the two groups.Results The blood of patients with autoimmune disease,healthy physical examinees and partial MM patients were divided into three layers,followed by serum,separation glue and red blood cells from top to bottom,and the proportion of serum and red blood cells was appropriate.Patients with abnormal blood separation were MM patients,and the abnormal blood was separated into four layers,successively from top to bottom:serum,red blood cell,separation glue and red blood cell.There was a small amount of serum in the upper layer,a increase of red blood cells in the lower layer,and a small amount of red blood cell in the bottom layer.Abnormal blood separation was found in 46 cases of the 282 MM patients(16.31%).Abnormal separation was found only in IgG(28 cases)and IgA(18 cases),accounting for 60.87%and 29.13%,respectively.The levels of TP and Ig in the abnormal group were higher than those in the control group,while the levels of Hb and Hct in the abnormal group were lower than those in the control group(all P<0.05).Conclusion Abnormal separation phenomenon occurred after centrifuged in patients with MM.In case of abnormal blood separation in daily work,timely communi

关 键 词：多发性骨髓瘤 分离胶 真空采血管 血液分离 临床意义 

分 类 号：R733.3[医药卫生—肿瘤]