20例IgD型多发性骨髓瘤的鉴定与结果分析

Identification and result analysis of 20 IgD multiple myelomas

目的：为了对多发性骨髓瘤中发病率较低的ＩｇＤ型进行深入研究；方法：笔者从１９９４年至１９９７年北京各医院送检的骨髓瘤标本中收集了２０例ＩｇＤ型多发性骨髓瘤（ＭＭ）标本，进行了免疫球蛋白定量和免疫固定电泳分析；结果：发现此病患者较其它型骨髓瘤年轻，常见于５０岁以下男性，血清蛋白电泳大多出现Ｍ带，免疫固定电泳图谱上可见患者血清与ＩｇＤ抗血清形成一条致密浓集的单克隆区带，ＩｇＤ型ＭＭ患者尿本周阳性率为８０％，其中尿入链阳性率为８１３％；结论：ＩｇＤ型ＭＭ大多数患者有本周蛋白尿，以入型为主，肾功能损害常见，预后较差。

Objective:To study IgD multiple myeloma.Methods: We collected 20 IgD multiple myeloma samples from 1994 to 1997.We measured the level of immunoglobulin and analyzed with immunofixation electrophoresis(IFE). Results: These patients were younger than other types of multiple myeloma.Serum protein electrophoresis can see monoclonal zone.The graph of IFE can see a compact monoclonal zone which is formed by serum of patient and antiserum of IgD .The positive rate of Bence Jones is 80%.The positive rate of λ light chain in urine is 81.3%.Conclusion: most of IgD multiple myeloma had Bence Jones of λ light chain.Damage of renal function was common.Prognosis is poor. [