多发性骨髓瘤肾损害10例临床分析

Clinical Analysis of 10 Patients with Kidney Injury in Multiple Myeloma

目的 :探讨多发性骨髓瘤 (multiplemyeloma ,MM)肾损害的误漏诊原因并提出避免误漏诊的要点。方法 :对 1989年 6月～ 1999年 6月住院的MM患者中 10例并肾损害者进行临床分析。结果 :首发症状缺乏特异性 ,误诊率 80 %。结论 :对于有原因不明的贫血、骨痛、蛋白尿、高球蛋白血症和骨折 ,应及时进行本周氏蛋白、免疫球蛋白及免疫电泳测定 ,多部位的骨髓穿刺和骨X线摄片 ,避免误漏诊。

Objective To study the reasons of misdiagnosis and missed diangosis on kidney injury in multiple myeloma and propose the key points to avoid misdiagnosis.Methods To make clinical analysis in the 10 patients with kidney injury in multiple myeloma,which were hospitalized from June 1989 to June 1999. Results The specificity is lack in the initial symptom.The misdiagnosis rate is 80%.Conclusions For unknown anemia,ostalgia,albuminuria,hyperglobulineemia and fracture,the determination of Bence Jones protein,immunoglobulin and immunoelectrophoresia,the multi position bone marrow puncture and the osteomyelography should be made in time to avoid misdiagnosis and missed diagnosis.