摘要
目的 通过对 798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 分析M蛋白阳性患者的病种分布与年龄、性别的关系 ,多发性骨髓瘤 (MM)与非MM首发症状的比较 ,以及MM各型免疫球蛋白含量的差异与非MM患者M蛋白的特点。结果 M蛋白阳性的病例中 ,MM 6 48例 (81 2 % ) ,华氏巨球蛋白血症 (WM) 34例 (4 3% ) ,良性或继发性单克隆免疫球蛋白疾病 116例 (14 5 % )。患者平均年龄 5 8 3岁 ,男、女性别病种分布无差异性。MM首发症状以腰酸、骨痛为主 ,非MM则以发热、纳差、乏力为主 ,二者差异具有显著性。MM中IgG型 2 90例 (4 4 8% ) ,IgA型 143例 (2 2 1% ) ,轻链型 138例 (2 1 3% ) ,IgD型 45例 (6 9% ) ,非分泌型 30例 (4 6 % ) ,双克隆型2例 (0 3% )。除IgD型外 ,各型中κ和λ比较差异无显著性。良性或继发性单克隆免疫球蛋白升高者平均M蛋白含量 (11 3± 6 5 )g/L ,其中意义未明的单克隆免疫球蛋白血症 (MGUS) 5 5例 ,占M蛋白阳性患者的 6 9% ;非霍奇金淋巴瘤 (NHL) 35例 ,占 4 4%。结论 M蛋白阳性主要见于MM。此外 ,尚可见于MGUS、NHL。
Objective To improve the understanding of the diseases with positive M protein by analyzing 798 cases, so as to reduce the failure and error of diagnosis. Methods The relations of diseases with the types of the disease and age and sex of the patients were analyzed. The presenting symptoms of multiple myeloma(MM) and non MM were compared. The difference of Ig content among each type of MM and the characteristics of M protein in non MM were also studied. Results In 798 cases with positive M protein, there were 648 cases of MM (81 2%) and 34 cases of Waldenstrom′s maeroglobulinemia (WM) (4 3%). The remaining 116 cases (14 5%) were benign or secondary monoclonal gammopathies. The average age of the patients was 58 3 years, and there was no difference of disease incidence between men and women. There was a marked difference between MM and non MM in the presenting symptoms which were mainly lumbago and bone pain in MM but fever, weight loss and fatigue in non MM. 648 cases of MM included 290 cases of IgG type (44.8%), 143 of IgA type (22 1%), 138 of light chain type (21 3%), 45 of IgD type (6 9%), 30 of non secretion type (4 6%) and 2 of double clonal type (0 3%). There was no marked distinction between κ and λ chain except in IgD type. The average M protein content of 116 cases of benign or secondary monoclonal gammopathies was (11 3±6 5) g/L. 55 of the 116 cases were monoclonal gammopathy of undetermined significance (MGUS), which accounted for 6 9% of all the cases. 35 cases were non Hodgkin′s lymphoma (NHL)(4.4%). Conclusion M protein was mainly discovered in MM; it may also be discovered in MGUS, NHL, WM and other diseases. It is essential to have a better understanding of these diseases.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2001年第6期398-400,共3页
Chinese Journal of Internal Medicine
