摘要
目的:对伴有肾功能不全的多发性骨髓瘤(MM)患者的临床特征及其影响因素进行研究。方法:选取2020年1月—2023年3月在我院血液肿瘤科住院的146例诊断MM患者为研究对象,按肾功能水平分为肾功能正常组(98例)和肾功能不全组(48例)。采集并记录所有患者的相关临床资料和实验室检查指标,对其临床特点与肾功能不全的相关影响因素进行回顾性分析。结果:在146名MM患者中肾功能不全发病率为32.9%;与肾功能正常组相比,肾功能不全组血红蛋白较低,年龄、尿酸、校正钙、LDH、白细胞计数、血清β_(2)-微球蛋白和骨髓浆细胞比例较高,差异有统计学意义(P<0.05);经Logistic回归因素分析显示校正钙和血清β_(2)-微球蛋白是MM患者发生肾功能不全的影响因素。ROC曲线分析表明校正钙曲线下面积为0.689 1,灵敏度56.3%,特异度82.7%,最佳截取值为2.465mmol/L;β_(2)-微球蛋白曲线下面积为0.897 9,灵敏度81.3%,特异度83.7%,最佳截取值为6.315mg/L。结论:MM患者肾功能不全的患病率较高,且校正钙和β_(2)-微球蛋白为肾功能不全的关键因素,并对MM患者肾功能损伤有一定的辅助诊断价值,应关注上述指标并及时采取针对性防治措施,以改善患者生活质量和预后。
Objective:To investigate and analyze the clinical characteristics and related risk factors of multiple myeloma(MM)patients with renal insufficiency.Methods:A total of 146 patients diagnosed with MM who were hospitalized in the department of hematology of our hospital from January 2020 to March 2023 were selected as the research objects.According to the level of renal function,they were divided into normal renal function group(98 cases)and renal insufficiency group(48 cases).Their clinical and laboratory data were collected,and their clinical characteristics and impact on renal insufficiency were retrospectively analyzed.Results:The incidence of renal dysfunction was 32.9%in 146 MM patients.Compared with the normal renal function group,the renal insufficiency group had lower hemoglobin and higher age,uric acid,corrected calcium,LDH,white blood cell count,serumβ2-microglobulin and bone marrow plasma cell ratio(P<0.05).Multivariate Logistic analysis showed that corrected calcium andβ2-microglobulin were risk factors for renal insufficiency in MM patients.ROC curve analysis showed that the area under the curve of corrected calcium was 0.6891,the sensitivity was 56.3%,the specificity was 82.7%,and the best cut-off value was 2.465mmol/L.The area under the ROC curve ofβ2-microglobulin was 0.8979,the sensitivity was 81.3%,the specificity was 83.7%,and the best cut-off value was 6.315mg/L.Conclusion:The correction of calcium andβ2-microglobulin are the key factors of renal dysfunction and have certain auxiliary diagnostic value for renal dysfunction in MM patients.The above indicators should be paid attention to and targeted prevention and treatment measures should be taken in time to improve the quality of life and prognosis of MM patients.
作者
徐佳澳
应燕萍
赵慧函
何雨
XU Jiaao;YING Yanping;ZHAO Huihan(The First Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi 530021)
出处
《医学理论与实践》
2024年第2期189-191,195,共4页
The Journal of Medical Theory and Practice
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220418)
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220414)。
