血液净化治疗多发性骨髓瘤合并急性肾损伤的疗效观察

Efficacy of blood purification in the treatment of multiple myeloma complicated with acute kidney injury

目的探讨血液净化治疗多发性骨髓瘤合并急性肾损伤的疗效。方法选取2010年6月至2016年6月间山东省临朐县人民医院收治的90例多发性骨髓瘤合并急性肾损伤患者,采用随机数字表法分为观察组与对照组,每组45例,观察组患者在化疗基础上加用血液净化治疗,对照组患者给予化疗,对比两组患者临床疗效、生化指标及不良反应。结果观察组患者临床总有效率为84.4%,对照组患者总有效率为55.6%,两组比较差异有统计学意义(P<0.05)。观察组治疗后血清尿素氮(BUN)、肌酐(Cr)、β_2-微球蛋白(β_2-MG)和胱抑素C(CysC)水平分别为(5.74±2.11)mmol/L、(73.21±10.99)μmol/L、(1.70±0.36)mg/L和(0.58±0.15)mg/′L,低于对照组患者的BUN(6.23±1.56)mmol/L、Cr(89.63±15.42)μmol/L、β_2-MG(2.89±0.58)mg/L和CysC(1.39±0.78)mg/L,且两组患者治疗后BUN、Cr、β_2-MG和CysC四者水平与治疗前相比均降低,差异均有统计学意义(均P<0.05)。结论血液净化治疗多发性骨髓瘤合并急性肾损伤效果显著,能够降低肾脏损伤程度,安全性较高。

Objective To explore and analyze efficacy of blood purification in the treatment of multiple myeloma complicated with acute renal injury.Methods Select 90 patients with multiple myeloma complicated with acute kidney injury treated at Linqu People＇s Hospital from June 2010 to June 2016.Using random number table method,these patients was divided into an observation group and control group with 45 patients in each group.Patients in the control group received chemotherapy.Apart from the above treatment,patients in the observation group received blood purification treatment Clinical curative efficacy,levels of biochemical indexes and adverse reactions were compared between the two groups.Results Overall efficacy rate was 84.4% for the observation group and 55.6% for the control group（P〈0.05）.Blood urea nitrogen（BUN）,creatinine（Cr）,β2-microglobulin（β2-MG） and cystatin C（CysC） level was 5.74 ±2.11 mmol/L,73.21 ± 10.99 μmol/L,1.70 ±0.36 mg/L and 0.58 ±0.15 mg/L respectively for the observation group and 6.23 ± 1.56 mmol/L,89.63 ± 15.42 μmol/L,2.89 ± 0.58 mg/L and 1.39 ± 0.78mg/L respectively for the control group.Compared with before treatment,BUN,Cr,β2-MG and CysC levels decreased after treatment in both groups,with more statistically significant decrease in the observation group（P〈0.05）.Conclusion Blood purification shows high efficacy in the treatment of multiple myeloma complicated with acute which can reduce the degree of kidney damage and has high security.