血液净化对多发性骨髓瘤并急性肾损伤的疗效分析

Clinical effect of blood purification therapy in patients with multiple myeloma and acute renal injury

目的探讨多发性骨髓瘤并急性肾损伤患者进行血液净化疗法的临床效果。方法选取2013年6月至2014年6月间简阳市人民医院收治的42例多发性骨髓瘤并急性肾损伤患者,根据随机数字表法分为观察组和对照组,每组各21例。观察组患者采用血液净化+化疗法+急性肾损伤疗法,对照组患者采用化疗+急性肾损伤治疗,比较两组患者的临床效果;评估比较两组患者治疗前后的乳酸脱氢酶(LDH)、C反应蛋白、血清球蛋白和血沉等临床实验室指标情况;评估比较两组患者治疗前后的血清中尿素氮(BUN)、肌酐(Cr)、β_2-微球蛋白(β_2-MG)和胱抑素C(CysC)等临床指标情况。结果观察组患者的临床有效率为90.5%,对照组为57.1%,组间差异有统计学意义(P<0.05);两组患者治疗后LDH、C反应蛋白、血清球蛋白和血沉等临床指标均有改善,但观察组患者治疗后LDH、C反应蛋白、血清球蛋白和血沉指标显著优于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后血清中BUN、Cr、β_2-MG和CysC等临床指标均有改善,观察组患者治疗后血清中BUN、Cr、β_2-MG和CysC等临床指标显著高于对照组,差异均有统计学意义(P<0.05)。结论多发性骨髓瘤并急性肾损伤进行血液净化疗法,可显著改善患者的临床症状,降低肾损害程度,临床效果确切,值得临床推广。

Objective To investigate the clinical effect of blood purification therapy in patients with multiple myeloma and acute renal injury. Methods The 42 multiple myeloma tumor and acute kidney injury patients in People＇ s Hospital of Jianyang City from June 2013 to June 2014 were selected and divided into study group and control group. Patients in the study group received blood purification ＋ chemotherapy ＋ acute kidney injury therapy, whilie patients in the control group received chemotherapy ＋ acute kidney injury treatment. Clinical effect of two groups were compared. Lactic acid dehydrogenase （LDH）, C-reactive protein, serum globulin, erythrocyte sedimentation rate （ESR） and other clinical laboratory indicators before and after treatment of two groups were compared. The serum urea nitrogen （BUN）, creatinine （Cr）, beta 2-microglobulin （β2-MG）, cystatin C （CysC） and other clinical indicators before and after treatment of two groups were evaluated. Results The clinical efficiency rate of study group was 86. 7%, and control group was 57. 8%, there was significant difference between two groups （P 〈0. 05）. After treatment, LDH, C reactive protein, serum globulin, erythrocyte sedimentation rate and other clinical indicators in two groups were improved, but after treatment, LDH, C reactive protein, serum globulin, erythrocyte sedimentation rate of study group was significantly better than those in the control group, and the difference was statistically significant （ P 〈 0. 05 ）. BUN, Cr, β2-MG, CysC and other clinical indicators in two groups after treatment were improved, but after treatment, BUN, Cr, β2-MG, CysC and other clinical indicators in studygroup were significantly higher than those in the control group, and the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Blood purification therapy for multiple myeloma and acute renal injury can significantly improve the clinical symptoms, reduce the degree of renal damage. Clinical effect is exact, and it is worthy of clinical promotion.