多发性骨髓瘤患者校正血钙的临床分析(1)
摘 要：目的 分析我院多发性骨髓瘤患者校正前后血钙的差异，及校正后血钙与疾病的相关性。方法 回顾性分析我院2011年1月～2017年5月确诊的58例初发多发性骨髓瘤患者实验室检查、影像学检查等临床资料，对其血清白蛋白、血钙水平、血红蛋白、血肌酐、β2-微球蛋白、血清LDH、溶骨性病变等多项指标进行分析。结果 经血清白蛋白公式校正后D-S分期Ⅲ期的患者高钙血症发生率比较正前升高，Ⅰ期、Ⅱ期校正前后血钙差异无统计学意义(P>0.05)；高钙组血清LDH、溶骨性病变均高于非高钙组，差异有统计学意义(P<0.05)，而两组血红蛋白、肌酐、β2-微球蛋白相比，差异无统计学意义(P>0.05)；肾功能不全组血钙升高明显，校正后血钙更能准确提示患者病情严重程度。结论 多发性骨髓瘤校正后的血钙更能真实反映与之相符的疾病状态下真实的血钙水平，更能有效预测病情严重程度。
关键词：多发性骨髓瘤；血钙；肾损害
中图分类号：R733.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.026
, 百拇医药
文章编号：1006-1959(2018)10-0087-03
Clinical Analysis of Corrected Serum Calcium in Patients with Multiple Myeloma
FENG Jiang-fang
(Department of Hematology，Jincheng Hospital，Jincheng 048000，Shanxi，China)
Abstract：Objective To analyze the difference of serum calcium in patients with multiple myeloma before and after correction，and the correlation between serum calcium and disease.Methods The clinical data of 58 patients with primary multiple myeloma，which were confirmed in our hospital from January 2011 to May 2017，were analyzed.The clinical data such as serum albumin，blood calcium， hemoglobin，serum creatinine，β2-microglobulin，serum LDH，and osteolytic disease were analyzed.Results After correction of serum albumin formula，the incidence of hypercalcemia in patients with D-S stage Ⅲ was higher than that in non-hypercalcemia group，and there was no significant difference in serum calcium before and after correction in stageⅠand stageⅡ(P>0.05)，and the serum LDH and osteolytic lesions in high calcium group were higher than those in non-hypercalcemia group，the difference was statistically significant(P<0.05)，but there was no significant difference in hemoglobin，creatinine and β2-microglobulin between the two groups(P> 0.05).The blood calcium level in the renal insufficiency group was significantly increased.After correction，blood calcium could more accurately indicate the severity of the disease.Conclusion The corrected serum calcium level of multiple myeloma can reflect the true level of serum calcium in accordance with the disease and predict the severity of the disease more effectively.
, 百拇医药
Key words：Multiple myeloma；Serum calcium；Renal damage
多發性骨髓瘤(multiple myeloma，MM)是一种以骨髓中积聚恶性浆细胞为特征的克隆性疾病，机体发生浆细胞单克隆增殖，会破坏骨质，可引起骨痛、病理性骨折，浸润多个脏器，出现多脏器功能受损[1]。MM的发病率约占所有恶性肿瘤的1%，占血液系统肿瘤的10%～15%，在血液恶性肿瘤中发病率位列第二，仅次于非霍奇金淋巴瘤(non Hodgkin lymphoma，NHL)[2，3]。有文献报道，MM肾脏损害发生率为 60%～90%，肾脏损害是MM最常见和严重的并发症之一，是MM的第二大死亡原因[4]。根据近年来的研究认为，高钙血症是引起肾损害的重要因素之一，约25%～30%的MM患者伴有高钙血症，血钙可以作为一个独立因素，影响MM患者生存质量[5]。因此，研究高钙血症与MM疾病的关系显的尤为重要。本研究通过回顾性分析MM患者的血钙、血红蛋白、β2-微球蛋白、血清LDH、血肌酐、溶骨性病变等实验室指标，探讨血钙与疾病的关系。, 百拇医药(冯江芳)
关键词：多发性骨髓瘤；血钙；肾损害
中图分类号：R733.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.026
, 百拇医药
文章编号：1006-1959(2018)10-0087-03
Clinical Analysis of Corrected Serum Calcium in Patients with Multiple Myeloma
FENG Jiang-fang
(Department of Hematology，Jincheng Hospital，Jincheng 048000，Shanxi，China)
Abstract：Objective To analyze the difference of serum calcium in patients with multiple myeloma before and after correction，and the correlation between serum calcium and disease.Methods The clinical data of 58 patients with primary multiple myeloma，which were confirmed in our hospital from January 2011 to May 2017，were analyzed.The clinical data such as serum albumin，blood calcium， hemoglobin，serum creatinine，β2-microglobulin，serum LDH，and osteolytic disease were analyzed.Results After correction of serum albumin formula，the incidence of hypercalcemia in patients with D-S stage Ⅲ was higher than that in non-hypercalcemia group，and there was no significant difference in serum calcium before and after correction in stageⅠand stageⅡ(P>0.05)，and the serum LDH and osteolytic lesions in high calcium group were higher than those in non-hypercalcemia group，the difference was statistically significant(P<0.05)，but there was no significant difference in hemoglobin，creatinine and β2-microglobulin between the two groups(P> 0.05).The blood calcium level in the renal insufficiency group was significantly increased.After correction，blood calcium could more accurately indicate the severity of the disease.Conclusion The corrected serum calcium level of multiple myeloma can reflect the true level of serum calcium in accordance with the disease and predict the severity of the disease more effectively.
, 百拇医药
Key words：Multiple myeloma；Serum calcium；Renal damage
多發性骨髓瘤(multiple myeloma，MM)是一种以骨髓中积聚恶性浆细胞为特征的克隆性疾病，机体发生浆细胞单克隆增殖，会破坏骨质，可引起骨痛、病理性骨折，浸润多个脏器，出现多脏器功能受损[1]。MM的发病率约占所有恶性肿瘤的1%，占血液系统肿瘤的10%～15%，在血液恶性肿瘤中发病率位列第二，仅次于非霍奇金淋巴瘤(non Hodgkin lymphoma，NHL)[2，3]。有文献报道，MM肾脏损害发生率为 60%～90%，肾脏损害是MM最常见和严重的并发症之一，是MM的第二大死亡原因[4]。根据近年来的研究认为，高钙血症是引起肾损害的重要因素之一，约25%～30%的MM患者伴有高钙血症，血钙可以作为一个独立因素，影响MM患者生存质量[5]。因此，研究高钙血症与MM疾病的关系显的尤为重要。本研究通过回顾性分析MM患者的血钙、血红蛋白、β2-微球蛋白、血清LDH、血肌酐、溶骨性病变等实验室指标，探讨血钙与疾病的关系。, 百拇医药(冯江芳)