多发性骨髓瘤肾损害发病及其相关因素分析

The incidence and risk factors of kidney lesion in patients with multiple myeloma

目的探讨多发性骨髓瘤(MM)肾损害发病及其相关因素。方法统计1996年1月至2008年1月确诊的83例MM患者肾损害发生率,并对性别、年龄以及贫血、骨髓浆细胞比例、血清白蛋白、球蛋白、β2-MG、血钙、血磷、尿酸、LDH水平、尿本-周蛋白、多发性骨损害等肾损害发生相关因素进行分析。结果MM肾脏损害的发生率为51.8%(43/83),以慢性肾功能不全最常见。骨髓浆细胞比例和尿本-周蛋白与肾功能损害之间有显著相关关系(P<0.01);贫血、血清白蛋白、β2-MG、血钙、尿酸及多发性骨损害与肾脏损害有相关关系(P<0.05)。结论肾脏损害是MM的常见并发症,骨髓浆细胞增殖及尿轻链蛋白产生是MM肾脏损害的主要原因,且主要与肿瘤负荷有关。

Objective To investigate the incidence and risk factors of kidney lesion in patients with multiple myeloma （MM）. Methods 83 patients with MM were retrospectively analyzed in our department since January 1996. The incidence of kidney lesion in 83 cases was calculated and several relative factors were analyzed, including gender, age, anemia, plasma cell proportion in bone marrow, seralbumin, seroglobulin, β2 - microglobulin, blood calcium, blood phosphonium, uric acid, LDH level, urine Bence - Jones protein, and multiple bone lesion. Results The incidence of kidney lesion in these 83 patients was 51.8% （43/83）, and the most common kidney lesion was caused by chronic renal failure. There was a significant correlation between plasma cell proportion in bone marrow or urine Bence - Jones protein and renal function （ P 〈 0.01 ）. Anemia, seralbumin, β2 - microglobulin, blood calcium, uric acid or multiple bone lesion were correlated with kidney lesion （P 〈 0.05）. Conclusion Kidney lesion is a common complication of MM, proliferation of bone marrow plasmacyte and the quantity of urine Bence - Jones protein are main causes of kidney lesion in multiple myeloma, and predominantly correlated with tumor burden.