摘要
目的了解多发性骨髓瘤(multiple myeloma,MM)的首发症状与疾病的关系,以提高早期诊断率,减少误诊。方法回顾性分析2003—2012年127例MM的临床资料,分析总结患者的首发症状、首诊科室及疾病特点。结果本组首发表现主要为骨痛(38.59%)、乏力(14.17%)、肾损害(13.39%)、贫血(6.30%)等。首诊科室依次为骨科(29.92%)、肾病内科(16.54%)、血液科(14.17%)、心血管科(11.81%)等。全组共误诊114例,误诊率89.76%,仅13例首诊血液内科者确诊MM。免疫分型为IgG型(46.46%)、IgA型(26.77%)、轻链型(22.83%)、不分泌型(2.36%)、IgD型(1.57%)。结论 MM临床表现多样,各科医生应提高认识,尤其接诊伴贫血、球蛋白增高、骨质疏松的中老年患者时,应警惕MM,及时行相关检查,以尽早诊治。
Objective To learn initial symptoms of the first visit by patients with multiple myeloma （MM） so as to improve early diagnosis rate and reduce misdiagnosis rate. Methods Clinical data, initial symptoms, the first visit departments and characteristics of 127 patients with MM from 2003 to 2012 in our hospital were retrospectively analyzed. Results The initial symptoms of MM were bone pain （38.59%） , acratia （14.17%） , renal dysfunction （13.39%） and anemia （6.30%）. The first visit departments were orthopaedics （29.92%） , nephrology （16.54%） , hematology （14.17%） or cardiovascular （11.81%）. In the group, 114 patients were misdiaguosed （89.76%） , and only 13 patients were diagnosed in the department of haematology at first visit. The immunology types were IgG type （46.46%）, IgA type （26.77%）, light chain type （22.83%）, non-secretion type （2.36%） and IgD type （ 1. 57% ）. Conclusion Clinicians should pay more attention to middle and old aged patients especially with anemia, hyperglobulinaemia and osteoporosis for clinical manifestations diversity of multiple myeloma at first visit. Related checks should he performed to confirm diagnosis.
出处
《临床误诊误治》
2013年第4期25-27,共3页
Clinical Misdiagnosis & Mistherapy
