南京城北地区32例多发性骨髓瘤的回顾性分析

A Retrospective Analysis of 32 Cases of Multiple Myelomain the Northern Area of Nanjing

目的 通过总结分析多发性骨髓瘤(MM)患者的临床表现及实验室检查结果,了解MM发病的临床和实验室检查特点,为临床非血液科医生减少误诊漏诊提供帮助。方法 总结分析2013年至2022年的MM患者发病特点和实验室检查结果。结果 32例MM患者中,首发临床症状最常见的是骨痛(43.75%),其次是不同部位的感染(21.88%),第三位的是乏力、消瘦(15.63%),第四位的是头晕(9.37%)。实验室检查结果显示红细胞计数(RBC)、血清总蛋白(TP)和球蛋白(GLB)水平100%异常,血沉(ESR)结果96.88%异常,血红蛋白(HB)、红细胞压积(RCT)和β2微球蛋白(β2-MG)结果93.75%异常,白蛋白(ALB)和铁蛋白(TERR)结果90.63%异常,尿隐血、C反应蛋白(CRP)和国际化标准比率(INR)84.38%异常。外周血涂片红细胞呈缗钱状排列32例(100%)。骨X线及CT结果病理性骨折14例(43.75%),广泛性骨质破坏及溶骨性改变10例(31.25%),多处骨密度减低及骨质疏松8例(25%)。结论 MM临床表现复杂多样,首诊医生应根据临床表现和实验室检查结果及早明确诊断,为患者争取治疗时间,延缓患者的生存期和提高生活质量。

Objective By summarizing and analyzing the clinical manifestations and laboratory results of multiple myeloma(MM)patients,to better understand the clinical features and laboratory examination results of MM,and to facilitate clinical non-hematologists to reduce misdiagnosis and missed diagnosis.Methods A retrospective analysis of laboratory examination results and clinical features of MM patients from 2013 to 2020 was conducted.Results The most common first clinical symptoms of 32 patients were bone pain(43.75%),followed by infection in different parts(21.88%),fatigue and weight loss(15.63%),and dizziness(9.37%).Laboratory tests showed 100%abnormal red blood cell count(RBC),serum total protein(TP)and globulin(GLB),96.88%abnormal erythrocyte sedimentation rate(ESR),and 93.75%abnormal hemoglobin(HB),hematocrit(RCT)andβ2-microglobulin(β2-MG).Albumin(ALB)and ferritin(TERR)were 90.63%abnormal,while urinary occult blood,C-reactive protein(CRP)and international standard ratio(INR)were 84.38%abnormal.Rouleau alignment of erythrocyte in peripheral blood smears was found in 32 cases(100%).Bone X-ray and CT results showed that 14 cases(43.75%)had fracture bone pain,10 cases(31.25%)had extensive bone destruction and osteolytic changes,and 8 cases(25%)had multiple bone mineral density reduction and osteoporosis.Conclusion The clinical manifestations of MM are complex and diversified.The primary doctor should make an early diagnosis according to the clinical features and laboratory results,so as to prolong the treatment duration and the survival time and to further improve patients’quality of life.