以肾功能不全为首发症状MM患者的免疫球蛋白三系和IgM水平特征

IgM level of immunoglobulin in MM patients with renal dysfunction as the first symptom

目的:分析多发性骨髓瘤并发肾功能不全患者的临床特征。方法:回顾性分析我院收治的70例多发性骨髓瘤患者的临床资料,按照GFR取值,分为肾功能不全组和肾功能正常组。分别对性别、年龄、血红蛋白、白蛋白、血钙、校正血钙、尿酸、乳酸脱氢酶、免疫球蛋白(Ig A、IgG、IgM)参数进行统计学分析。对多发性骨髓瘤患者合并肾功能不全患者采用多元Logistic回归分析,确定各因素的关联性。结果:在免疫分型方面,IgM型和轻链型多发性骨髓瘤更容易发生肾功能不全,伴有肾功能不全的多发性骨髓瘤患者具有更低的血红蛋白,更高的血钙、校正钙浓度及血尿酸,均显著高于肾功能正常组(P<0.05)。而肾功能不全与健全组患者在性别、年龄、白蛋白、乳酸脱氢酶比例方面并无显著统计学差异。IgM水平与肾功能不全有较强的内在关联性。结论:伴有肾功能不全首发症状的多发性骨髓瘤患者通常与IgM的水平高低有一定的关联性。

Objective： Analyzing clinical characteristics of multiple myeloma patients with acute renal insufficiency. Methods： Clinical data of 70 patients with multiple myeloma were divided into two groups. Gender,age,hemoglobin,albumin,calcium,corrected calcium,uric acid,lactate dehydrogenase,immunoglobulins（ Ig A,IgG,IgM） parameters were analyed. Results： IgM type and light-chain multiple myeloma was more prone to kidney dysfunction,associated renal insufficiency in patients with multiple myeloma have lower hemoglobin,higher serum calcium,calcium concentration correction and uric acid were significantly higher than those with normal renal function（ P 〈0. 05）.There were no statistically significant difference between patients and healthy groups in gender,age,albumin,lactate dehydrogenase aspect ratio. Conclusion： With renal insufficiency as initial symptoms of patients with multiple myeloma IgM levels usually associated with a certain level of relevance.