48例多发性骨髓瘤的临床诊断分析

Clinical Diagnosis Analysis of 48 Cases with the Multiple Myeloma

目的分析多发性骨髓瘤的主要临床表现、骨髓细胞学检查及医技检查结果,加强对该病的认识,提高其诊断能力。方法结合主要临床表现、细胞形态学及医技检查联合确诊,依据国内多发性骨髓瘤标准[1]诊断。结果多发性骨髓瘤的临床表现繁多,常见骨痛(68.8%),贫血(66.7%),红细胞沉降率增快(85.4%),血红蛋白降低(60.4%),血球蛋白升高(89.6%),尿本周氏蛋白阳性(50.0%),骨质破坏(56.3%),本组48例多发性骨髓瘤患者骨髓象中均发现异常浆细胞,异常浆细胞在骨髓中占的比值与其对骨髓的损伤程度成正比。结论骨髓细胞学检查对多发性骨髓瘤具有特异诊断的意义,进行骨髓细胞学和多种理化检查可做出较准确的诊断。

Objective To analyse clinical symptoms, medullary cytology examination and medical technique diagnosis of multiple myeloma and enforce the knowledge and enhance the diagnosis capability of such disease. Methods The MM is diagnosed by domestic MM standard on the base of main clinical symptoms, cyto-morphology and medical technique. Results There are many clinical symptoms of MM, such as bone pain（68.8% ）, anaemia（66.7% ）, higher sedimentation rate of the red blood cell（ 85.4% ）, hematoglobin fall（60.4% ）, hematoglobin elevation （60.4%）, Bence-jones proteins in urine（50.0%）, bone destruction（56.3%）. Plasma cell disorders, whose ratio in the bone marrow has direct ratio with its destruct degree on the bone marrow, is found in the bone marrow samples of all the 48 sufferers of MM. Conclusion Medullary cytology examination has a meaning of different diagnosis to find Myeloma, and Myeloma can be more exactly diagnosed by the examination of medullary cytology and physico-chemical examinations.