多发性骨髓瘤肾损害临床特征及相关因素分析

Huang Kaiquan,Zhang Shufang,Shen Rong

目的观察多发性骨髓瘤(MM)肾损害的临床特征及相关因素。方法回顾分析153例MM患者临床资料,应用Cockcroft-Gault方程评估肾功能,按肌酐清除率(Ccr)低于60 ml.min-1.(1.73 m2)-1与不低于60 ml.min-1.(1.73m2)-1分A、B两组,进行两组间临床资料比较。结果肾功能损害是本病重要表现之一,高达84.3%,以肾损害症状首发者占17.6%,尿常规检查多表现为孤立性蛋白尿,血尿、管型尿相对少见。A组与B组比较,高钙血症、高尿酸血症、血高β2微球蛋白、贫血发生率高(P<0.05)。多元线性逐步回归分析显示:Ccr与年龄、血钙成负相关,与血红蛋白呈正相关(P<0.05)。结论MM肾损害有一定的临床特点,肾损害与年龄、高钙、高尿酸血症、贫血关系密切。

Objective To investigate the clinical features of renal impairment in patients with multiple myeloma（MM） and analyze the relevant factors.Methods The clinical materials of 153 patients with MM were retrospectively reviewed.Renal function was evaluated by Cockcroft-Gault equations.Patients were divided into two groups： group A： Ccr 60 ml·min^-1·（1.73m^2）^-1;group B： Ccr≥60 ml·min^-1·（1.73m^2）^-1.Results The incidence rate of renal damage was t 84.3%,and 17.6% of all the patients had the renal injury at the onset of MM.Simple proteinuria was the most common manifestation in urine routine examination while hematuria and casts were relatively rare.In contrast with group B,the rates of hypercalcemia,hyperuricemia,high β2-microglobulin levels and anemia in group A were significiantly higher（P0.05）than those in group B Multiple linear stepwise regression analysis showed that the Ccr negatively correlated with age and serum calcium,while positively associated with hemoglobin（P0.05）.Conclusion Renal impairment in patients with MM had some specific features and had a close relationship with age,hypercalcium,hyperuricemia and anemia.