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目的:分析多发性骨髓瘤的临床特征及比较不同化疗方案的临床疗效,进一步提高对该疾病的认识。方法:回顾性分析30例MM患者的临床、实验室检查及影像学资料、化疗方案及疗效评价。结果:30例MM患者以骨痛为首发症状的有21例,其中腰骶痛最多见,误诊6例,误诊率达20%;实验室检查:贫血25例,白细胞减少7例,血小板减少4例,肾功能不全9例,尿蛋白阳性12例,尿本周蛋白阳性8例,化疗3个疗程后白细胞及血色素较前明显升高,肌酐较前显著降低;30例骨髓检查均提示增生活跃或明显活跃,浆细胞1.5%~55.5%,均有原、幼浆细胞及浆细胞形态异常。21例X线提示有异常改变,部位主要在颅骨、肋骨及骨盆等。治疗以VAD、TD+亚砷酸、MP等化疗方案为主,各种方案比较无显著差异。结论:MM临床表现复杂多样,首诊常以骨痛、贫血及肾损害等为主,不同化疗方案比较无显著差异,宜进一步增加样本含量明确疗效差异。
Objective: To analyze the clinical features of multiple myeloma and compare the clinical efficacy of different chemotherapy regimens to further improve the understanding of the disease. Methods: Retrospective analysis of 30 cases of MM patients clinical, laboratory tests and imaging data, chemotherapy and efficacy evaluation. Results: Twenty-one MM patients had bone pain as the first symptom, of which 21 were the lumbosacral pain, 6 were misdiagnosed, and the misdiagnosis rate was 20%. Laboratory tests included 25 anemia, 7 leukopenia and 4 thrombocytopenia Cases, renal insufficiency in 9 cases, urine protein positive in 12 cases, urine week protein positive in 8 cases, three courses of chemotherapy after leukocyte and hemoglobin increased significantly compared with the former, creatinine was significantly lower; 30 cases of bone marrow examination showed hyperplasia Or significantly active, plasma cells 1.5% ~ 55.5%, all of the original, juvenile plasma cells and plasma cell morphology abnormalities. 21 cases showed abnormal X-ray changes, mainly in the skull, ribs and pelvis. Treatment with VAD, TD + arsenic trioxide, MP and other chemotherapy-based program, the various programs were no significant differences. Conclusion: The clinical manifestations of MM are complex and diverse. The first diagnosis is mainly bone pain, anemia and renal damage. There is no significant difference between different chemotherapy regimens, and it is necessary to further increase the sample content to clarify the difference in therapeutic effect.