摘要
目的分析多发性骨髓瘤(MM)肾功能损害发生及预后的影响因素。方法对1991年1月至2007年1月天津医科大学总医院血液肿瘤科确诊的74例MM患者进行病例总结及分析。结果MM肾功能损害的总发生率为56.8%。单因素相关分析显示,年龄、高血压病史、血红蛋白、血清白蛋白及球蛋白、血钙,血磷、血清β2-微球蛋白、骨髓浆细胞及幼稚浆细胞比例、Durie-Salmon分期、MM类型均与MM肾功能损害发生相关;多因素相关分析显示,高血压病史、血清白蛋白、β2-微球蛋白与MM肾功能损害发生相关,血清白蛋白为保护因素,其余二者为危险因素。化疗后完全缓解、中重度贫血接受红细胞输注对肾功能恢复有益。MM肾功能损害者较无肾功能损害者存活时间短,早期病死率高。结论高血压病史及高肿瘤负荷是MM肾功能损害发生的危险因素,有效的化疗及支持治疗对MM肾功能恢复有益。
Objective To analyse the occurrence and prognosis related factors of renal dysfunction in patients with multiple myeloma（MM）, Methods During Janaury 1991 and Janaury 2007 seventy-four cases of MM in Department of Hematology, Gernal Hospital of Tianjin Medical University were enrolled in this study. The occurrence,the risk factors and prognosis were analyzed. Results The incidence of renal dysfunction （RD） in MM was 56, 8%, Age, hypertention, hemoglobin, serum ALB, GLO, calcium,phosphonium, β2-MG, the percentage of plasma and immature plasma cells in bone marrow,Durie-Salmon stage and type of MM were associated with the incidence to RD with MM by monovariam analysis. Hypertention,serum ALB and β2-MG were associated with the incidence of RD with MM by multivariant analysis. ALB was the protected factor and the other two were risk factors. The renal function improved rapidly in the patients who received CR or blood transfusion for severe and moderate anemia. Compared with patients of normal renal funtion, RD patients survived shorter and had higher early death rate. Conclusion Hypertention and high tumor burden are risk factors of renal dysfunction in MM. Effective chemothemapv and supportive treatment helped renal function recovery.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第5期363-365,共3页
Chinese Journal of Practical Internal Medicine
