摘要
目的通过对1 256例M蛋白阳性病例的分析,提高对这类疾病的认识,减少误诊和漏诊。方法收集广州军区武汉总医院2012年6月至2013年6月1 256例M蛋白阳性的初诊患者相关资料,分析病例的病种分布与年龄、性别的关系,比较多发性骨髓瘤(MM)与非MM的首发症状,分析MM的M蛋白类型和M蛋白水平。结果 1 256例M蛋白阳性病例中,MM 1 215例(96.7%),良性或继发性单克隆免疫球蛋白疾病41例(3.3%)。患者男女比例1.34∶1,平均年龄63.1岁,50岁以下初诊患者306例(25.2%)。MM首发症状以腰痛、骨痛为主,非MM以发热、贫血、乏力为主,二者差异有统计学意义(P<0.05)。MM患者中IgG型742例(61.2%),IgA型280例(23.0%),IgM型81例(6.7%),IgD型36例(3.6%),轻链型53例(4.4%),双克隆M蛋白型12例(1.0%),非分泌型1例(0.1%),其中IgG、A、M、D型相应的免疫球蛋白显著增高。结论 M蛋白阳性主要见于MM,男性多于女性,且近两年发病更趋于年轻化,以IgG型为主。当患者出现腰痛、骨痛,且免疫球蛋白异常增高或降低时,应及时检查血清蛋白电泳和免疫固定电泳,必要时进行骨髓检查。
Objective To improve the understanding of M protein positive disease ,in order to reduce misdiag-nosis and missed diagnosis .Methods Clinical data of 1 256 patients with positive with M protein were analyzed to i-dentify the relationship between diseases distribution and age ,gender of patients ,the primary symptoms of multiple myeloma（MM） and non-MM ,and the types and levels of M protein in patients with MM .Results In all 1 256 cases positive with M protein ,there were 1 215 cases of MM （96 .7% ） and 41 cases of benign or secondary monoclonal gammopathies （3 .3% ） .The male female ratio of patients was 1 .34∶1 .The average age of patients was 63 .1 years old ,and 306 cases （25 .2% ） were less than 50 years old .There was significant difference between MM and non-MM in primary symptoms（P＆lt;0 .05） .In patients with MM ,the mainly primary symptoms were lumbago and bone pain , but in patients with non-MM ,the mainly primary symptoms were fever ,weight loss and fatigue .In patients with MM ,742 cases （61 .2% ） were IgG type ,280 cases （23 .0% ） were IgA type ,81 cases （6 .7% ） were IgM type ,36 ca-ses （3 .6% ） were IgD type ,53 cases （4 .4% ） were light chain type ,12 cases （1 .0% ） were double-clonal type and 1 case （0 .1% ） was non-secretion type .The levels of immunoglobulin corresponding to M protein in IgG ,A ,M and D type were significantly higher .Conclusion Positive of M protein could be discovered mainly in patients with MM . The dominant type of MM could be IgG type ,the incidence might be younger in recent years ,and the incidence rate in males cold be higher than females .Examination of serum protein electrophoresis and immunofixation electrophoresis should be performed promptly ,when patients are with lumbago and bone pain ,and the levels of immunoglobulin are abnormally increased or decreased .Bone marrow examination should also be performed ,when it is necessary .
出处
《检验医学与临床》
CAS
2014年第8期1042-1043,共2页
Laboratory Medicine and Clinic
