摘要
[目的]对比分析多发性骨髓瘤导致骨质疏松椎体压缩性骨折与原发性骨质疏松性椎体骨折的临床发病特征、血清β2-微球蛋白(β2-MG)差异,为多发性骨髓瘤的早期确诊提供依据。[方法]2009年10月~2016年5月以骨质疏松性椎体压缩骨折为首诊入院患者共40例,记录临床特点、血清β2-微球蛋白水平和影像特征。[结果]按β2-MG检测和影像检查最终诊断多发性骨髓瘤致椎体并病理性骨折患者20例(骨髓瘤组),原发性骨质疏松性椎体致病理性骨折患者20例(骨质疏松组)。骨髓瘤组男性多女性,而骨质疏松组女性多于男性,两组性别构成差异有统计学意义(P<0.05);骨髓瘤组年龄明显小于骨质疏松组,差异有统计学意义(P<0.05)。β2-微球蛋白含量骨髓瘤组为(3.76±0.80)mg/L,骨质疏松组为(1.45±0.70)mg/L,两组间差异有统计学意义(P<0.05)。40例患者均可见胸腰段椎体压缩性骨折,无椎体及椎旁占位性改变。骨质疏松组20例仅表现为单纯骨质疏松性椎体骨折征象。骨髓瘤组20例中,13例病椎横截面可见虫蚀样、穿凿性骨质缺损,部分有局灶性死骨形成及钙化。血清β2-MG用于多发性骨髓瘤的最佳诊断临界值为3.08mg/L(敏感度为85.0%,特异度为85.0%)。[结论]血清β2-MG是诊断多发性骨髓瘤的敏感指标之一,对于骨质疏松性椎体压缩骨折出现β2-MG异常增高者,需要高度警惕多发性骨髓瘤存在的可能。
[Objective] To compare the clinical characteristics and β2–microglobulin of osteoporotic fracture secondary to the multiple myeloma (MM) versus primary osteoporosis (PO), and provide a reference for the early diagnosis and treatment planning of MM.[Methods] A total of 40 patients with osteoporosis vertebral compression fracture were admitted to the hospital from October 2009 to May 2016. The clinical characteristics,β2-microglobulin, imaging features were documented and com pared.[Results] Based on β2-microglobulin, and radiographic features, 20 patients were diagnosed of MM and 20 patients of PO. The MM group proved male-dominated, while the PO was female-dominated, which was statistically significant (P<0.05). The patients in the MM group were significantly younger than those in the PO group (P<0.05). The β2-microglobulin proved (3.76±0.80) mg/L in MM group, while (1.45±0.70) mg/L in the PO group, which was statistically significant (P<0.05). In term of radiographic evaluation, all the 40 patients presented osteoporotic vertebral compression fracture (OVCF) without extraspinal bone destruction. All patients in the PO group had only simple OVCF, whereas 13 patients in the MM group revealed worm-eat en like bony destruction, penetrated bone defect, local necrosis and calcification. The optimal cutoff value of serum β2-MG for the diagnosis of MM was 3.08 mg/L with sensitivity of 85.0% and specificity of 85.0%).[Conclusion] Serum β2-MG is one of the sensitive indicators for the diagnosis of MM. For patients with osteoporotic vertebral compression fractures, an abnormally high β2-MG should be considered the possibility of MM..
作者
陈华星
施能兵
蔡海源
许尘鏖
胡晓源
刘异
CHEN Hua-xing;SHI Nengbing;CAI Hai-yuan;XIU Chen-ao;HU Xiao-yuan;LIU Yi(The Second People's Hospital of Jinmen City,Jinmen448000 ,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第19期1765-1769,共5页
Orthopedic Journal of China
