113例多发性骨髓瘤校正血钙的意义

Significance of corrected serum calcium in multiple myeloma patients

目的 分析正血钙在多发性骨髓瘤(MM)对判断预后及指导治疗方面的临床意义。方法 采用回顾性方法对113例MM患者的血钙水平以同时抽血所没得血清白蛋白浓度进行校正后,进行正前后血钙水平及高钙血症发生率的比较。结果 多发性骨髓瘤Ⅰ期患者血钙水平校正前后分别为(2.41±0.087)mmol/L和(2.376±0.149)mmol/L,两者无显著差异(P>0.05)。Ⅱ期患者的血钙水平在校前后分别为(2.264±0.372)mmol/L和(2.376±0.092)mmol/L,两者有显著 性差异(P<0.05),Ⅲ期患者血钙在校正前后分别为(2.377±0.360)mmol/L和(2.539±0.399)mmol/L,两者有显著差异(P<0.01),校正后高钙血症发生率(31.0％)比校正前(17.7％)显著升高(P<0.05)。结论 常规检测血钙值低估了MM患者血钙的真实水平,校正血钙比血钙在MM的诊断,指导治疗及预后方面更具有临床应用价值。

Objective To analyze the significance of corrected serum calcium (CSCa) in diagnosis and prognosis with multiple myeloma patients. Methods The level of serum calcium were adjusted by synchronous serum albumin concentration retrospectively. Results The level of serum calcium and CSCa of paients with MM at Ⅰ phase were 2.41 ±0.087mmol/L and 2.376 ±0.149mmol/L, Ⅱ phase were 2.264 ±0.372mmol/l and 2.376 ± 0.092mmol/L, Ⅲ phase were 2.377 ±0.360mmol/L and 2.539 ±0.399mmol/L. There exists significant difference between serum calcium and CSCa in MM patients at Ⅱ, Ⅲ phase (P<0.05,P<0.01)re-spectively,but no significant difference at Ⅰ phase (P>0.05). The incidence of hypercalcemia before adjustment and after were 17.7% and 31.0%, there exists significant difference between them (P<0.05). Conclusions The concentration of serum calcium by regular test undrerestimate true value of serum calcium in patients with MM, CSCa can be used more useful than serum calcium in guiding the di-agnosis,direction of therapy and the prognosis of MM.