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目的探讨多发性骨髓瘤患者(MM)低白蛋白血症的原因。方法1997-01~2004-08对浙江大学附属邵逸夫医院71例多发性骨髓瘤患者的年龄、血钙、Hb、肾功能、骨质破坏、骨髓浆细胞比例、球蛋白、M蛋白等与白蛋白进行相关性分析;并对高球蛋白(>35g/L)和非高球蛋白组的白蛋白、胆固醇、血钙、Hb、浆细胞比例及D-S分期情况进行比较。结果MM患者白蛋白水平与球蛋白及M蛋白有相关性(P<0.05);高球蛋白组血清白蛋白和胆固醇水平明显低于非高球蛋白组(P<0.05);但两组间的D-S分期及Hb水平、骨髓浆细胞比例均无差异(P>0.05)。结论MM患者白蛋白水平下降主要是由于球蛋白升高所致,其机制可能与肝脏白蛋白减少有关;而肿瘤负荷对其影响较小。
Objective To investigate the causes of hypoalbuminemia in patients with multiple myeloma (MM). Methods From January 1997 to August 2004, 71 patients with multiple myeloma at Run Run Shaw Hospital of Zhejiang University were evaluated for age, serum calcium, Hb, renal function, bone destruction, proportion of bone marrow plasma cells, globulin, M protein, The correlations of albumin, albumin, cholesterol, serum calcium, Hb, plasma cell ratio and DS staging were compared between high globulin (> 35g / L) and non-globulin groups. Results The albumin level in patients with MM was correlated with globulin and M protein (P <0.05). Serum albumin and cholesterol levels were significantly lower in patients with high globulin than those in patients with non-globulin (P <0.05) DS staging and Hb level, bone marrow plasma cells were no difference (P> 0.05). Conclusions The decrease of albumin level in MM patients is mainly attributed to the increase of globulin, which may be related to the decrease of hepatic albumin. However, the tumor burden has little effect on it.