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初诊多发性骨髓瘤患者合并肾损害的临床特征及危险因素分析
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Abstract:
目的：探究初诊多发性骨髓瘤患者合并肾损害的临床特征及危险因素分析。方法：回顾性分析2019年8月~2024年8月于北华大学附属医院血液内科收治的46例初诊多发性骨髓瘤患者临床资料，肾小球滤过率 < 60 ml/(min？1.73m2)定义为肾功能损害，将患者分为肾损害组与非肾损害组，比较两组患者的临床特征，采用多因素logistics回归分析多发性骨髓瘤患者合并肾损害的影响因素。结果：两组患者的血红蛋白、乳酸脱氢酶、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及β2-微球蛋白比较差异具有统计学意义(P < 0.05)，且肾损害组乳酸脱氢酶及β2微球蛋白水平高于非肾损害组，血红蛋白、总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇水平低于非肾损害组；经多因素logistics回归分析显示乳酸脱氢酶及β2-微球蛋白为多发性骨髓瘤患者合并肾损害的独立危险因素。结论：肾损害为初诊多发性骨髓瘤患者高发的并发症。多发性骨髓瘤合并肾损害患者临床多表现为高水平的β2-微球蛋白及乳酸脱氢酶。高β2-微球蛋白及高乳酸脱氢酶血症均为初诊MM患者合并肾损害的危险因素。
Objective: To investigate the clinical characteristics and risk factors of renal impairment in patients with newly diagnosed multiple myeloma. Methods: The clinical data of 46 patients with multiple myeloma admitted to the Department of Hematology, North China University of Science and Technology Affiliated Hospital from August 2019 to August 2024 were retrospectively analyzed. Renal function impairment was defined as a glomerular filtration rate (GFR) < 60 ml/(min？1.73 m2). The patients were divided into the impaired renal function group and the non-impairment group, and the clinical features of the two groups were compared. The influencing factors of renal impairment in patients with multiple myeloma were analyzed by multivariate logistic regression analysis. Results: There were significant differences in hemoglobin, lactate dehydrogenase (LDH), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and β2-microglobulin between the two groups (P < 0.05). The LDH and β2-microglobulin levels were higher in the impaired renal function group than in the non-impairment group, while the hemoglobin, total cholesterol, HDL-C, and LDL-C levels were lower in the impaired renal function group. After multivariate logistic regression analysis, LDH and β2-microglobulin were independent risk factors for renal impairment in patients with multiple myeloma. Conclusion: Renal impairment is a common complication in patients with newly diagnosed multiple myeloma. High levels of β2-microglobulin and lactate dehydrogenase are clinically manifested in patients with multiple myeloma-related renal impairment. High β2-microglobulin and high lactate dehydrogenase levels are independent risk factors for renal impairment in patients with newly diagnosed multiple myeloma.
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