多发性骨髓瘤合并肾损伤患者的临床表现及预后影响因素分析  

Clinical manifestations and prognostic factors analysis of patients with multiple myeloma complicated with renal injury

作　　者：鲍妍 杨翠[2] 王树龙[1] 王云[1] 韩惠淑 姚明瑞 刘向东[1] BAO Yan;YANG Cui;WANG Shulong;WANG Yun;HAN Huishu;YAO Mingrui;LIU Xiangdong(Hospital of Nephrology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,He’nan,China;Department of Hematology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,He’nan,China)

机构地区：[1]新乡医学院第一附属医院肾脏病医院,河南新乡453100 [2]新乡医学院第一附属医院血液内科,河南新乡453100

出　　处：《癌症进展》2024年第16期1791-1793,1821,共4页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220591)。

摘　　要：目的探讨多发性骨髓瘤(MM)合并肾损伤患者的临床表现及预后影响因素分析。方法收集MM合并肾损伤患者的病历资料,分析MM肾损伤患者的临床表现。对所有患者随访1年,根据预后情况分为预后良好(n=90)和预后不良(n=31),采用Logistic回归模型分析MM合并肾损伤患者预后的影响因素。结果MM合并肾损伤患者最常见的首发症状为贫血(72.73%),其次为感染(44.63%)、颜面及双下肢浮肿(42.98%)、血压升高(33.88%)。MM合并肾损伤患者最常见的病理类型为管型肾病(48.76%),其次为淀粉样变(25.62%)。预后不良与预后良好MM合并肾损伤患者的尿酸、β_(2)-微球蛋白、血镁水平比较,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,尿酸、β_(2)-微球蛋白、血镁水平均为MM合并肾损伤患者预后的影响因素(P﹤0.05)。结论贫血、感染、颜面及双下肢浮肿、血压升高、管型肾病、淀粉样变是MM合并肾损伤患者常见的临床表现。尿酸、β_(2)-微球蛋白、血镁均为MM合并肾损伤患者预后的影响因素。Objective To explore the clinical manifestations and prognostic factors analysis of multiple myeloma(MM)patients with renal injury.Method The medical records of MM patients complicated with renal injury were collected and the clinical manifestations of MM patients complicated with renal injury were analyzed.All patients were followed up for 1 year and divided into good prognosis(n=90)and poor prognosis(n=31)according to the prognosis,and the influencing factors of prognosis of MM complicated with renal injury patients were analyzed by Logistic regression model.Result The most common first symptom of MM complicated with renal injury patients was anemia(72.73%),followed by infection(44.63%),edema of the face and lower limbs(42.98%),and elevated blood pressure(33.88%).The most common pathological type of MM complicated with renal injury patients was tubular nephropathy(48.76%),followed by amyloidosis(25.62%).There were statistically significant differences in uric acid,β_(2)-microglobulin and magne-sium levels between MM complicated with renal injury patients with poor prognosis and good prognosis(P<0.05).Multi-variate Logistic regression analysis showed that uric acid,β_(2)-microglobulin and blood magnesium were influencing fac-tors of prognosis of MM complicated with renal injury patients(P<0.05).Conclusion Anemia,infection,edema of the face and lower limbs,elevated blood pressure,tubular nephropathy and amyloidosis are common clinical manifestations in MM complicated with renal injury patients.The uric acid,β_(2)-microglobulin and blood magnesium are influencing factors of prognosis of MM complicated with renal injury patients.

关 键 词：多发性骨髓瘤 肾损伤 临床表现 影响因素 

分 类 号：R733.3[医药卫生—肿瘤]