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本文报告单株丙种球蛋白病19例,其中多发性骨髓瘤10例,巨球蛋白血症4例,良性单株丙种球蛋白病(BMG)5例。在10例多发性骨髓瘤病人中,血清MIg浓度为2.2±1.4g％,免疫电泳分型IgG 6例,IgA 3例,IgD 1例,轻链κ 7例,λ3例,尿凝溶蛋白和轻链8例阳性。6例并发肺炎,3例肾功能衰竭,高尿酸血症和淀粉样变性各1例。4例巨球蛋白血症,血清IgM 3.1±1.3g％,3例有冷球蛋白,分型Mκ 3例,Mλ1例。血浆粘度均增高,2例用换血浆疗法和苯丁氨酸氮芥治疗好转。5例BMG,血清MIg 1.6±0.9g％,IgG 4例,IgA 1例,κ 3例,λ2例。经随访一年以上,临床及骨髓均正常。血和尿的免疫化学检查对于诊断本病是很重要的。
In this paper, 19 cases of single gammopathy were reported, including 10 cases of multiple myeloma, 4 cases of macroglobulinemia and 5 cases of benign single myeloid disease (BMG). In 10 patients with multiple myeloma, the concentration of serum MIg was 2.2 ± 1.4g%, immunophenotyping IgG was 6, IgA was 3, IgD was 1, light chain κ was 7, λ 3, urine coagulation protein and 8 cases of positive light chain. 6 cases complicated by pneumonia, 3 cases of renal failure, hyperuricemia and amyloidosis in 1 case. 4 cases of macroglobulinemia, serum IgM 3.1 ± 1.3g%, 3 cases of cryoglobulins, Mk 3 cases, Mλ1 cases. Plasma viscosity were increased in 2 cases with plasma exchange therapy and phenylcholine nitrogen mustard treatment improved. 5 cases of BMG, serum MIg 1.6 ± 0.9g%, IgG 4 cases, IgA 1 cases, κ 3 cases, λ 2 cases. After more than one year follow-up, the clinical and bone marrow were normal. Immunochemical tests of blood and urine are important for the diagnosis of this disease.