济宁市多发性骨髓瘤流行病学调查研究

Epidemioiogical investigation of multiple myeloma in Jining City

目的分析2015年济宁市初诊多发性骨髓瘤（MM）患者的临床资料，为MM的流行病学研究提供理论依据。方法选择2015年1月1日至12月31日济宁市114例初诊MM患者为研究对象。研究对象主要来源于“济宁市疾病预防控制中心肿瘤上报系统”、二级及以上级别医院的医院信息系统（HIS）及“济宁市医疗保险管理中心信息系统”3个信息平台。统计学分析2015年济宁市MM发病率、发病性别分布、发病年龄分布、发病地区分布、MM临床分期及M蛋白类型分布、首发症状分布及肾功能损害相关临床特点。结果①2015年济宁市MM发病率为1．38／10^5。②男性MM发病率为1．68／10^5，女性发病率为1．14／10^5，二者比较，差异有统计学意义（x2=4．176，P=0．041）。③男性MM患者的平均发病年龄为（65．9±9．9）岁，女性为（65．3±9．8）岁，二者比较，差异无统计学意义（t=0．334，P=0．584）。④农村MM发病率为2．24／10^5，城镇MM发病率为0．59／10^5，二者比较，差异有统计学意义（x2=41．007，P〈0．001）。⑤临床分期系Ⅲ期MM患者为57例（50．0％，57／114）。M蛋白类型主要为IgG型，占43．0％（49／114）。⑥首次就诊临床表现中，以骨骼疼痛（32．5％，37／114），乏力（21．9％，25／114）最常见。⑦肾功能正常与肾功能异常的MM患者的血红蛋白、β2=微球蛋白（MG）水平、血清Ca2＋浓度比较，差异有统计学意义（x2=4．154，P=0．042；x2=14．233，P〈0．001；x2=4．600，P=0．032）。结论20t5年济宁市MM发病年龄较欧美国家年轻，男性MM发病率高于女性，农村MM发病率明显高于城镇。首次就诊时MM患者临床分期主要为Ⅲ期。而血红蛋白（Hb）水平、血清Ca2＋浓度、β2-MG水平与MM患者的肾功能异常关系密切。

Objective To analyze clinical data of newly diagnosed multiple myeloma （MM） in Jining City in 2015, and to provide the theoretical basis for the epidemiological study of MM. Methods From 1 January 2015 to 31 December 2015, 114 patients with newly diagnosed MM were selected as the subjects in Jining City. The data of research subjects were selected from ＂Cancer Reporting System of Jining Disease Control and Prevention Center＂ , hospital information system （HIS） of second-graded or above hospitals in Jining City, and ＂Information System of Jining Medical Insurance Management Center＂. The incidence rate of MM, distribution of gender, age and region, MM clinical stages, types of M protein, primary symptoms, and clinical features associated with renal damage were observed in Jining City in 2015. Results （Din 2015, the incidence rate of MM in Jining City was 1.38/10^5. （1）The male incidence rate of MM was 1.68/10^5, and that of female was 1. 14/100 000. The incidence rate of MM between male and female was statistically significant（x2 =4. 176 ,P=0. 041）. （2）The median age of onset in male MM patients was （65.9 ±9.9） years old, and that of the females were （65.3± 9.8） years old. The difference between them was not statistically significant（t= 0. 334, P=0. 584）. QThe incidence of MM in rural areas was 2.24/105 , and the incidence of MM in urban areas was 0.59/105. There was significant difference between them（x2 =41. 007,P〈0. 001）. QThere were 57 patients（50.0%, 57/114） with stage II MM. The main type of M protein was immunoglobulin （Ig） G, accounting for 43. 0% （49/114）. OThe main primarysymptoms of MM were bone pain （32.5%, 37/114） and fatigue （21.9%, 25/114） at the first visit. （7）There were significant differences in levels of hemoglobin （Hb）, levels of β2- microglobulin （MG）, serum Ca2＋ concentration between normal renal function patients and abnormal renal function patients （x2 = 4. 154,P = 0. 042;Z2 =14. 233,P〈0. 001;x2 =4. 600,P=0. 032）. Conclusions In 2015, the age of MM onset in Jining City was younger than that in Europe and America, and the incidence rate of MM in male was higher than that in female. The incidence rate of MM in rural areas was higher than that in urban areas. The clinical stage of MM patients is usually stage Ⅲ at the first visit. Hemoglobin, serum Ca2＋ concentration and β2-MG are closely related to the impairment of renal function in patients with MM.