多发性骨髓瘤患者血钙异常的临床分析
发表时间:2014-01-20 浏览次数:559次
张芳,刘彦琴,王吉刚等.多发性骨髓瘤患者血钙异常的临床分析[J].吉林医学,2013,34(28):5817-5819.
多发性骨髓瘤 知识脉络 血钙 知识脉络 血清白蛋白
张芳 刘彦琴 王吉刚 白颖 刘景华 周凡
中国人民解放军沈阳军区总医院血液科,辽宁,沈阳,110016
2013
5817-5819
知网,万方
目的:探讨多发性骨髓瘤(Multiple Myeloma,MM)血钙特点,正确认识多发性骨髓瘤血钙水平,提高对多发性骨髓瘤的认识.方法:回顾性分析我院2007年至今收入院的104例初治及复发多发性骨髓瘤患者的血钙水平及同时抽血所得的血清白蛋白浓度进行校正,分析校正前后血钙异常比例的变化及血钙异常的相关因素.结果:①校正前血钙水平为(2.516±0.426)mmol/L,校正后血钙水平为(2.615±0.431)mmol/L,差别有显著性意义.②多发性骨髓瘤患者Ⅰ期血钙水平校正前后分别为(2.23±0.12)mmol/L和(2.185±0.167)mmol/L,差别无统计学意义;Ⅱ期血钙水平校正前后分别为(2.179±0.187)mmol/L和(2.352±0.171)mmol/L,差别有统计学意义;Ⅲ期血钙水平校正前后分别为( 2.588±0.432)mmol/L和(2.683±0.442)mmol/L,差别有显著性意义.③低钙组与正常血钙组差别有统计学意义的指标为血白蛋白,高钙组与正常血钙组差别有统计学意义的指标为血红蛋白、肌酐、尿素、尿酸、球蛋白.④多发性骨髓瘤IgG型患者血钙水平为(2.429±0.379)mmol/L,IgA型患者血钙水平为(2.560±0.399)mmol/L,轻链型患者血钙水平为(2.684±0.593)mmol/L,IgG和轻链型血钙水平的差异有显著性意义.结论:血钙异常是多发性骨髓瘤的重要表现,与多因素有关;校正血钙更能准确的反映出MM患者的血钙水平,更具有临床应用价值. ObjectiveExplore the serum calcium characteristics of multiple myeloma,a correct understranding of the multiple myeloma serum calcium level,and raise awareness of multiple myeloma.MethodThe serum calcium level of 104patients with multiple myeloma were measured and corrected by the serum albumin levels measured simultaneously,compared the serum calcium levels before and after correction by serum albumin,and analyze abnormal serum calcium and its related factors in multiple myeloma.Results1.The level of serum calcium and CSCa of paients with MM were(2.516±0.426)mmol/L and (2.615±0.431)mmol/L,there are significant diffrerence between the total serum calcium level before and after correction.The level of serum calcium and CSCa of paients with MM at Ⅰphase were(2.23±0.12)mmol/L and (2.185±0.167)mmol/L,Ⅱphase were (2.179±0.187)mmol/L and(2.352±0.171)mmol/L,Ⅲphase were( 2.588±0.432)mmol/L and(2.683±0.442)mmol/L,The significant difference between serum calcium and CSCa in MM paients at ⅡⅢ phase(P<0.05) respectively,but no significant difference at Ⅰphase(P>0.05).3.The difference between the low calcium group and the nomral group had statistically significant was albumin(P<0.05),the difference between the high calcium group and the nomral group had statistically significant was serumcreatinine,hemoglobin,BU,UA,GLB.Conclusionserum calcium exception is the important manifestations of multiple myeloma,and multi-factors.Corrected serum calcium more accurately reflect the serum calcium level of patients with multiple myeloma,and more clinical value.