28例多发性骨髓瘤的实验室分析

Laboratory Tests and Analysis 28 Cases of Multiple Myeloma

目的:研究多发性骨髓瘤(Multiple Myelome,MM)细胞形态学及其他实验室相关指标特征,了解MM的发病特点,减少误诊率。方法:回顾性分析28例多发性骨髓瘤患者的实验室检查资料。结果:28例多发性骨髓瘤中,20例有不同程度的贫血(血红蛋白平均为89 g/L);22例血沉增加,平均为116.8 mm/h;蛋白尿15例,平均为(++);本组中有10例肾功能有病理性改变,尿素氮平均为18.35mmol/L;28例都做尿本周氏,阳性为11例,占39.3%;23例(85.2%)检出M蛋白;26例(92.9%)骨髓片中发现原、幼浆细胞及浆细形态异常。23例免疫分型中,IgG型13例、IgA型3例、轻链型5例、未分泌型1例、未定型2例。结论:由于MM临床表现复杂多样,误诊率较高,因此对多发性骨髓瘤患者诊断时,应用骨髓瘤细胞形态学诊断结合实验室相关指标检查,能够提高多发性骨髓瘤诊断的准确性,为临床诊断提供可靠依据。

Objective： To study the cytomorphology and other associated laboratory features of multiple myeloma （ MM ） for the purpose understanding the basic onset characteristics and reducing the rate of misdiagnosis. Method： Laboratory data of 28 cases with MM were analysed in retrospective study. Result： Among 28 patients of MM, 20 of them have various degrees of hemopthisis （ the average level of Hb is 89 gpL） ;22 of them have growth of eruthrocutes sedimentation rate and the average level is 116.8 mmph ;15 of them have proteinuria and the average is （ ＋ ＋ ）, positive accounting to 39.3 % among 28 cases tested this week urine protein;10 of them have pathological change in their nephric function and the average level of urea mitrogen is 18.35 mmol/L ; 23 of them have M protein and positive rate accounting to 85.2 % ; 26 of them have tested abnormal cytomorphology and the proportion of tumor cells in bone marrow puncture. 3 cases were IgG type, 3 cases were IgA type, 5 cases were light chain type, 1 case was non - secretion type and 2 cases were others among 23 cases according to immunity classification. Conclusion： The cytomorphology together with associated laboratory analysis of MM may increase the accuracy rate of MM and provide reliable foundation to clinical diagnosis due to no cause for myeloma identified and the higher rate of misdiagnosis.