86例初诊多发性骨髓瘤患者血钙水平的临床资料分析

Clinical Analysis of Serum Calcium Level in 86 Cases of Newly Diagnosed Multiple Myeloma

目的:研究86例初诊多发性骨髓瘤(multiple myeloma,MM)患者血钙水平及血钙与临床特征的相关性。方法:回顾性分析我院2009年至2016年收治的86例初诊多发性骨髓瘤患者的临床资料,收集患者性别、年龄、血红蛋白、白蛋白、球蛋白、肌酐、尿酸、血磷、β2-微球蛋白、免疫分型及疾病分期等临床数据,将患者血钙进行校正并分组:低血钙(<2.20 mmol/L),正常血钙(2.20-2.60 mmol/L)和高血钙(>2.60 mmol/L)。分析患者临床特征与血钙水平之间的相关性,比较低钙组与非低钙组的临床特征。结果:多发性骨髓瘤患者低血钙、正常血钙及高血钙组病例数校正前分别为58例(67.4%)、18例(20.9%)及10例(11.6%),经校正后低钙组占34例(39.5%),正常钙组36例(41.9%),高血钙16例(18.6%);年龄、球蛋白、肌酐、尿酸、血磷与血钙水平呈不同程度正相关,而性别、血红蛋白、白蛋白和β2-微球蛋白与血钙水平无相关性;低钙组与非低钙组的发病年龄、球蛋白、肌酐及血磷水平差异显著(P<0.05),而性别、血红蛋白、白蛋白、尿酸、β2-微球蛋白、免疫分型及临床分期2组间无差异(P>0.05)。结论:多发性骨髓瘤患者存在高钙血症,也存在低钙血症,而且低钙血症的发生率并不低。多发性骨髓瘤患者血钙水平与年龄、球蛋白、肌酐、尿酸、血磷等因素相关,因此有必要对具有生理活性的离子钙水平进行校正。

Objective: To investigate the serum calcium level in 86 patients with newly diagnosed multiple myeloma(MM) and its correlation with clinical features. Methods: The clinical data of 86 patients with newly diagnosed multiple myeloma in our hospital from 2009 to 2016 were retrospectively analyed. Clinical data of sex, age, hemoglobin, albumin, globulin, creatinine, uric acid, serum phosphorus, β2-microglobulin, immunophenotyping and disease staging were collected. After the serum calcium level was corrected, the patients were grouped into low serum calcium(<2.20 mmol/L), normal serum calcium(2.20-2.60 mmol/L) and high serum calcium(>2.60 mmol/L). The correlation between the clinical characteristics and the serum calcium level was analysed, the clinical characteristics between the low and non-low calcium group were compared. Results: The number of cases in low, normal and high serum cnlcium groups before correction was 58(67.4%), 18(20.9%) and 10(11.6%) respactively, while the number of cases in 3 group after correction was 34(39.5%), 36(41.9%) and 16(18.6%) respectively. The age, globulin, creatinine, uric acid and serum phosphorus levels were positively correlated with serum calcium level in patients with multiple myeloma, while the sex, hemoglobin,albumin and β2-microglobulin levels did not correlated with serum calcium level. There was significant difference in the age, globulin, creatinine and serum phosphorus between low calcium and non-low calcium group(P<0.05). However the differences of sex, hemoglobin, albumin, uric acid, β2-microglobulin, immunophenotyping and clinical stage were not statistically significant(P>0.05). Conclusion: Multiple myeloma patients suffered from both hypercalcemia and hypocalcemia, and the incidence of hypocalcemia is not low. The levels of serum calcium in patients with multiple myeloma correlate with age, globulin, creatinine, uric acid, serum phosphorus level and other factors, thus it is necessary to correct the level of ionized calcium with physiological activity.