多发性骨髓瘤实验数据分析

Analysis of experimental data of multiple myeloma

目的探讨多发性骨髓瘤(multiplemyeloma,MM)细胞的主要形态以及其他实验室相关指标特征,了解MM发病的显著特点,从而降低误诊率。方法对30例MM患者的实验室检查资料进行回顾性分析。结果 30例MM患者中,22例(73.3%)血红蛋白平均为88g/L,出现有不同程度的贫血特征;24例(80.0%)血沉增加,平均为117.6mm/h;蛋白尿18例(60.0%),平均为(++);16例(53.3%)肾功能发生病理性改变,尿素氮平均为19.26mmol/L。30例均做尿本周氏,阳性13例(43.3%);26例(86.7%)检出M蛋白;28例(93.3%)骨髓片中发现原、幼浆细胞及浆细胞形态异常。30例免疫分型中,IgG型16例,占53.3%;IgA型8例,占26.7%;IgM型1例,占3.3%;游离轻链型5例,占16.7%。其中IgG和IgA型以κ型为主。结论由于MM临床表现较复杂,误诊率较高,因此对MM患者诊断时,应进行实验室相关指标检查和MM细胞形态学诊断。

] Objective To study the main forms and other relevant index feature of multiple myeloma （MM） cells, understand pathogenesis features of myeloma,in order to reduce the rate of misdiagnosis. Methods The data of laboratory examination in 30 MM patients were retrospectively analyzed. Results Of 30 MM patients, 22 patients （73.3%） were found to have an average hemoglobin of 88 g/L, and a different degree of anemia characteristics; 24 patients（80.0% ） had an increased erythrocyte sedimentation rate,with an average of 117.6 mm/h; 18 patients （60. 0% ） had proteinuria,with average of （＋＋） ; 16 patients （53.3%） had the pathological changes of renal func- tion, with an average of blood urea nitrogen of 19.26 mmo]./L. In 30 patients urine Bence Jones positive was found in 13 patients,accounted for 43.3% ; M protein was found in 26 patients（86.7% ） ; in 28 patients＇ （93.3%） bone marrow slice abnormalities of the original,immature plasma cells and plasma in cell morphology was found. In 30 patients of immune typing, type IgG was found in 16 cases, accounted for 53.3 % ; type IgA was found in 8 patients, accounted for 26. 7% ; type IgM in one patient, accounted for 3.3% ; free light chain type in 5 patients, accounted for 16.7%. In IgG,IgA type K type was the main. Conclusion The clinical manifestation of MM is complex, the misdi- agnosis rate is higher,thus in the diagnosis of MM, the examination of laboratory related indicators and cell morphology should be used.