摘要
目的总结并分析多发性骨髓瘤(MM)合并胸腔积液的临床特点。方法回顾2000年1月~2016年12月于北京大学第一医院确诊的MM患者,记录其人口学、MM分期及分型、实验室检查等资料进行统计分析。结果本研究共纳入348例MM患者,合并胸腔积液者130例(37.4%),其中骨髓瘤性胸腔积液(MPE)9例(2.6%)。合并胸腔积液组总蛋白、白蛋白、钙、补体C3含量低于无胸腔积液组,乳酸脱氢酶(LDH)含量高于无胸腔积液组(P<0.05)。多元回归分析显示低C3血症(OR=0.282,95%CI 0.096~0.830,校正P<0.01)和低水平血清总蛋白(OR=0.979,95%CI 0.966~0.993,校正P<0.01)是MM合并胸腔积液的独立危险因素;MPE组LDH和腺苷脱氨酶(ADA)含量高于非MPE组(P<0.05)。结论胸腔积液是MM的并发症之一,低C3血症和低水平血清总蛋白是MM合并胸腔积液的独立危险因素,胸腔积液高LDH和ADA水平提示出现MPE的风险增高。有关MM合并胸腔积液、特别是MPE的发病机制尚待进一步研究。
Objective To analyze the clinical characteristics of multiple myeloma （MM） with pleural effusion. Methods This was a retrospective study. Patients diagnosed of MM from January 2000 to December 2016 in Peking University First Hospital were included. Demographic, clinical and laboratory tests data were collected prospectively and analyzed statistically. Results The overall rate of pleural effusion was 37.4%（130/348） in MM patients, and myelomatous pleural effusion （MPE） rate showed to be 2.6%（9/348）. The levels of total protein （TP）, albumin, calcium, and complement 3 （C3） in the pleural effusion group were lower than those in the non-pleural effusion group, and the LDH level in the pleural effusion group was higher than that in the non-pleural effusion group （P 〈 0.05）. Hypocomplementemia of C3 （OR=0.282, 95%CI 0.096-0.830, P 〈 0.01） and lower level of TP（OR=0.979, 95%CI 0.966-0.993, P 〈 0.01） were inde- pendent risk factors of pleural effusion production according to multiple Logisitic regression. The levels of LDH and adenosine deaminase （ADA） were higher level in the MPE group than those in the non-MPE group （P 〈 0.05）, Con- clusion Pleural effusion is one of the complications of MM, in which MPE is rare. Hypocomplementemia of C3 and low- er level of TP seem to be independent risk factors of pleural effusion production in MM. High level of LDH and ADA in pleural effusion remind the high risk of MPE. The pathophysiology of pleural effusion, especially MPE in MM needs further research in the future.
作者
许慧莹
周伟炜
林连君
刘新民
XU Huiying ZHOU Weiwei LIN Lianjun LIU Xinmin(Department of Geriatrics, Peking University First Hospital, Beijing 100034, China)
出处
《中国医药导报》
CAS
2017年第15期31-34,共4页
China Medical Herald
基金
北京市自然科学基金资助项目(7151011)
