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目的探讨多发性骨髓瘤(MM)肾损害的临床特征及应用血液透析治疗的效果评估。方法回顾性分析郑州市第三人民医院1998年1月至2015年2月收治的26例以肾损害为首发症状的MM患者临床资料及评估应用血液透析后患者各项生理指标的变化。结果Ig G、Ig A、Ig M、不分泌型分别占65.4%、19.2%、7.7%、7.7%,中位发病年龄63岁。26例患者共透析59次,平均2次,经透析治疗加化疗后一般情况改善,26例患者均于1~2个疗程化疗后脱离血液透析,血清肌酐(SCr)水平可稳定于正常或正常高限。结论以肾损害为首发症状的MM中,以Ig G型最常见。早期应用血液透析治疗有助于肾功能恢复,有硼替佐米参与的联合化疗对此类患者疗效满意。
Objective To investigate the clinical features of multiple myeloma (MM) and evaluate the effect of hemodialysis treatment. Methods The clinical data of 26 MM patients with kidney lesion as the first symptom and the changes of various physiological indexes after hemodialysis were retrospectively analyzed in Zhengzhou Third People ’s Hospital from January 1998 to February 2015. Results Ig G, Ig A and Ig M accounted for 65.4%, 19.2%, 7.7% and 7.7% respectively, with a median onset age of 63 years. Twenty-six patients were dialyzed a total of 59 times for an average of 2 times. After dialysis and chemotherapy, the general situation was improved. All 26 patients were separated from hemodialysis after 1-2 cycles of chemotherapy, and serum creatinine (SCr) level could be stabilized at normal or normal level High limit. Conclusion MM with kidney damage as the first symptom is the most common Ig G type. Early application of hemodialysis treatment is conducive to the recovery of renal function, bortezomib in combination with chemotherapy in patients with satisfactory results.