28例M蛋白阳性患者的临床表现和实验结果分析

Analysis on Clinical Manifestation and Lab Results of M Protein Positive Patient

目的通过对28例M蛋白阳性患者的临床表现和实验结果的分析,提高对这类疾病的认识,进而提高检验质量和临床诊断价值,减少误诊和漏诊,更好地服务于临床。方法（1）血清蛋白电泳;（2）免疫球蛋白（IgGI、gAI、gM）定量;（3）总蛋白和白蛋白定量和A/G比值;（4）尿中BJP（本周氏蛋白）定性;（5）血液β2-微球蛋白质含量;（6）其它检测项目：包括血尿酸、血清钙、HGB及ESR等。结果28例M蛋白带,20例位于γ区,5例在α2~β区之间,3例在β~γ区之间;总蛋白显著升高,ALB及A/G比值明显下降;免疫球蛋白测定20例IgG升高,6例IgA升高,2例IgM升高;HGB均有不同程度下降;尿BJP检测：12例阳性占43%;28例中β2-微球蛋白含量均〉500μg/mL（正常值85μg/mL±59μg/mL）;ESR均有显著性升高（〉100 mm/h）,而血钙12例升高以腰痛、骨痛、病理性骨折和骨瘤为首发症状。结论结合患者临床症状（均以腰痛、骨痛、病理性骨折和骨瘤为首发症状）和实验结果分析,28例均为多发性骨髓瘤（MM）。其中,20例为IgG型,占71.4%;6例为IgA型,占21.4%;2例为IgM型,占7.1%。本组28例多发性骨髓瘤（MM）患者中,男18例（占64.3%）,女10例（占33.7%）,患者年龄范围为37~79岁之间,发病年龄平均为58岁。

Objective To improve understanding, lab quality and diagnostic value of this disease so that to decrease misdiagnosis. Methods The serum protein electrophoresis, immunoprotein quantity, ratio of A/G, BJP, quantity of B2, uric acid, HGB and ESR were detected. Results The protein brand of 28 cases were 20 cases in γ area, 5 cases in α2 -β area and 3 cases in β-γ area. The IgG, IgA, IgM were increased in 20 cases, IgA 6 cases and IgM 2 cases. The total protein and ESR were increased. The ALB, A./G and HGB were decreased. The BJP positive was in 12 cases. microprotein was more than 500 μg/mL. The first symptom of blood calcium increaseds is back pain, pathological fracture and tumor. Conclusion According to clinical manifestation and lab results, 20 cases of MM patient IgG type is 20 cases, IgA type is 6 cases and IgM type is 2 cases with age of 37 - 79 years - old.