多发性骨髓瘤并发急性肾衰竭35例临床分析

Clinical analysis for 35 cases of multiple myeloma with acute renal failure

目的探讨多发性骨髓瘤(MM)并发急性肾衰竭(ARF)的临床特点及治疗措施。方法回顾性分析我院2002年1月至2009年6月收治的35例MM并发ARF患者的临床资料。结果 35例患者中,男性25例,女性10例,平均年龄为62.5±15.6岁。贫血28例,发生蛋白尿30例,高钙血症23例,高尿酸血症25例,出现肾小管功能损害20例,合并高血压4例。予以化疗、肾脏保护、血液透析等综合治疗,化疗有效患者肾功能逆转率为61.54%,化疗无效患者肾功能逆转率为23.7%,总逆转率为51.43%。结论 MM起病隐匿,临床表现复杂多样,误诊率高,ARF发生率高,有效的综合治疗措施,可改善MM合并ARF患者的预后。

Objective To study the clinical features and therapeutic measures of patients with multiple myeloma （MM） accompanied acute renal failure （ARF）.Method Retrospective analysis of 35 MM accompanied ARF patients admitted in our hospital was done from January 2002 to June 2009.Results 25 males and 10 females,the average age of 62.5±15.6 years.28 cases of anemia,30 cases of proteinuria,23 cases of hypercalcemia,25 cases of hyperuricemia,20 cases of renal tubular dysfunction,4 cases of hypertension.After comprehensive treatment including chemotherapy and reno-protection and hemodialysis,reversed rate of renal function in chemotherapy effective group was 61.54%,reversal rate of renal function in chemotherapy ineffective group was 23.7%,and the total reversal rate was 51.43%.Conclusion The clinical manifestations of MM are cccult in onset,with high rate of misdiagnosis and the incidence.Effective comprehensive treatments can improve the prognosis of MM accompanied ARF.