多发性骨髓瘤合并肾损害23例临床特征分析

The clinical features of 23 cases with multiple myeloma accompanied renal disease

目的:探讨多发性骨髓瘤(MM)合并肾功能不全临床特点,以及与肾功能不全发生有关的可能因素。方法:对23例MM合并肾损害病人进行临床资料总结分析。结果:全部病人均有肾损害,均有不同程度贫血,初次诊断为肾脏病5例(21%),合并肾功能不全7例(30.43%)。发病年龄≥60岁与<60岁、血尿酸≥420μmol/L与血尿酸<420μmol/L、血钙≥2.9mmol/L与<2.9mmol/L、r球蛋白≥22%与r球蛋白<22%两组病人肾功能不全的发生率比较均有统计学意义(P<0.05)。结论:多发性骨髓瘤是骨髓异常浆细胞增生的恶性疾病,好发于中老年人,起病隐匿,全身各系统均可受累,临床表现复杂,容易误诊。老年MM病人以及有高尿酸血症者、高球蛋白血症、高钙血症者易发生肾功能不全。

Objective.. To investigate the clinical features and relative factors of multiple myeloma（MM） accompanied renal insufficiency. Methods.. To summarize clinical information of 23 patients with multiple myeloma accompanied renal disease. Results： All of the patients accompanied renal disease were normocytic, normochromic anemia. 5 cases（21%）were first diagnosed, 7 cases （ 30. 43%） occurred renal insufficiency of all the patients. Cases aged≥60 andS60, Serum uric acid≥120 μmol/l, andS420μmol/L,serum calciumS〉2.9 mmol/L andS2.9 mmol/L, and r--serum globulin≥22% and〈 22% were all significantly increased in cases of renal insufficiency group（P〈0.05）. Conclusion： Multiple myeloma is a malignant disease which clinical findings are complex and is not easy to diagnose correctly. The factors which induce to renal insufficiency include advanced age, hyperuricemia, high globulin and high calcium.