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本文对15例多发性骨髓瘤肾病观察发现,全部有蛋白尿,4例呈肾病综合征的表现,故蛋白尿为本病主要特征之一。其中孤立性蛋白尿6例,脓尿、管型尿5例,并发肾盂肾炎2例。有3例以蛋白尿为首发症状,误诊为慢性肾炎,有2例以急性肾功能裒竭发病,而误诊为慢性肾炎尿毒症,误诊率为33％。尿凝溶蛋白阳性者14例。多发性骨髓瘤肾病时贫血,高钙血应,高尿酸血旋,血清球蛋白及免疫球蛋白增高是本病又一较为突出的特征。本文同时并对本病主征蛋白尿、肾功能不全、肾小管功能障碍、泌尿系感染的发生机制和影响因素以及鉴别诊断要点进行探讨。
In this paper, 15 cases of multiple myeloma nephropathy found that all have proteinuria, 4 cases showed nephrotic syndrome, so proteinuria is one of the main features of the disease. Including proteinuria in 6 cases, pyuria, tubular urine in 5 cases, complicated by pyelonephritis in 2 cases. There are 3 cases of proteinuria as the first symptom, misdiagnosed as chronic nephritis, 2 cases of acute renal failure, and misdiagnosed as chronic nephritis uremia, misdiagnosis rate was 33%. Urine coagulation protein positive in 14 cases. Multiple myeloma nephropathy anemia, hypercalcemia, hyperuricemia, serum globulin and immunoglobulin increased the disease is another more prominent feature. This article at the same time and the main symptoms of proteinuria, renal insufficiency, renal tubular dysfunction, urinary tract infection mechanism and influencing factors and differential diagnosis to explore.