多发性骨髓瘤40例临床分析

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多发性骨髓瘤40例临床分析

摘要目的：探讨多发性骨髓瘤（mm）的临床特点，分析误诊原因。方法：回顾分析40例多发性骨髓瘤患者的临床资料。结果：40例患者中，贫血症状33例，骨骼疼痛28例，双下肢活动障碍3例，发热3例，有明确感染部位9例，下肢水肿7例，蛋白尿20例，肾衰竭14例，出血倾向3例，误诊18例。结论：多发性骨髓瘤是浆细胞恶性单克隆增殖性疾病，临床表现复杂多样，为减少漏诊及误诊，争取早期发现、诊断与治疗。

关键词多发性骨髓瘤浆细胞诊断临床特点

Clinical analysis of 40 cases of multiple myeloma

Chen Doujia

Department of Hematology，Hospital Affiliated to Zunyi Medical College（Zunyi City，Guizhou），563000

AbstractObjective：To explore the clinical features of multiple myeloma，and analyze the reason of misdiagnosis.Methods：The clinical data of 40 cases with multiple myeloma were retrospectively analyzed.Results：In 40 cases，33 cases had anemia symptoms.28 cases had bone pain.3 cases had both lower extremities movement disorder.3 cases had fever.9 cases had the clear infection position.7 cases had lower limb edema.20 cases had proteinuria.14 cases had renal failure.3 cases had hemorrhagic tendency.18 cases were misdiagnosed.Conclusion：Multiple myeloma is a plasma cell malignancy monoclonal proliferative diseases.The clinical manifestations are diverse and complex.In order to reduce the missed diagnosis and misdiagnosis，it should be early detected，diagnosed and treated.

Key wordsMultiple myeloma；Plasma cell；Diagnose；Clinical characteristics

多发性骨髓瘤（multiple myeloma，MM）是浆细胞恶性单克隆增殖性疾病，目前仍被视为不可治愈的疾病，其临床表现多样，易导致误诊及漏诊。笔者对近年来40例因不同原因收治他科，而最后确诊为多发性骨髓瘤转入血液科治疗的患者的临床资料进行总结，其中误诊病例18例，分析临床特点，现报告如下。

资料与方法

方法：对40例患者的临床资料进行分析。

结果

多发性骨髓瘤是浆细胞的一种恶性肿瘤，受累骨髓呈多发性、局灶性损害。国外报道的发病年龄平均为60岁，100mm/小时；⑥血涂片红细胞呈缗钱样排列；⑦肝功能中总蛋白增高，白蛋白与球蛋白比例倒置，球蛋白异常；⑧高钙血症；⑨骨骼影像学有溶骨性破坏或病理性骨折[3]。根据以上情况进行筛选检查，可进一步检查血免疫球蛋白、蛋白电泳、尿本周氏蛋白以及骨髓检查，减少本病的漏诊及误诊，争取早期发现、诊断与治疗。

参考文献

4孙玲玲，张天彪，纪斌.多发性骨髓瘤肾损害60例诊治及误诊分析[J].中国误诊学杂志， 2010，10（15）：3640.