多发性骨髓瘤合并肾损伤的实验室特征

An analysis on laboratory characteristics of multiple myeloma complicated with renal injury

目的研究多发性骨髓瘤(multiple myeloma,MM)合并肾损伤实验室特征,及对多指标的联合诊断效能进行评估。方法回顾性分析2018年6月至2021年3月南方医科大学南方医院及南部战区总医院血液内科收治的MM患者的临床资料,包括157例MM患者,其中合并肾损伤的MM患者为30例,非肾损伤患者为127例,比较实验室检查结果,分析MM合并肾损伤危险因素,并对单个指标检测与联合检测在MM合并肾损伤中的诊断效能进行比较。结果本研究共157例MM患者,其中合并肾损伤的MM患者为30例,非肾损伤患者为127例,研究发现肾损伤组的尿素氮、尿酸、β2-微球蛋白、校正钙离子、中性粒细胞/淋巴细胞(neutrophil/lymphocyte ratio,NLR)高于MM未合并肾损伤组(P<0.05)。此外,校正钙离子升高、β2-微球蛋白水平升高、NLR升高为MM合并肾损伤的独立危险因素。β2-微球蛋白、校正钙离子及NLR三者联合检测诊断的敏感性和特异性更高。结论β2-微球蛋白、校正钙离子和NLR是MM肾损伤的危险因素,且具有较好的预测价值。

Objective To explore the laboratory characteristics of multiple myeloma(MM)complicated with renal injury,and evaluate the effectiveness of diagnosis combined with multiple index.Methods The clinical data from 157 patients with MM including 30 complicated with renal injury and 127 without renal injury who had been treated from June 2018 to March 2021 in the department of Hematology,Nanfang Hospital and General Hospital of the Southern Theater of the Chinese People’s Liberation Army were retrospectively analyzed.The laboratory results were compared,the risk factors complicated with renal injury were analyzed,and the diagnostic efficiency of single detection was compared with that of combined detection in MM complicated with renal injury.Results Levels of urea nitrogen,uric acid,β2-microglobulin,and calcium-calibration,and ratio of neutrophil/lymphocyte(NLR)were higher in MM patients complicated by renal injury than in those without renal injury(P<0.05).An increase in calcium-calibration,β2-microglobulin or NLR were the independent risk factors for MM with renal injury.The combined detection ofβ2-microglobulin,calcium-calibration and NLR has higher sensitivity and specificity.Conclusions Calcium-calibration,β2-microglobulin and NLR were independent risk factors for MM with renal injury and have better predictive value.