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目的探讨老年多发性骨髓瘤(MM)患者神经系统损害的机制,包括引起神经系统病变的原因及发病机理。方法回顾性分析21例并发神经系统损害的老年MM患者的临床资料,并结合既往文献,对神经系统损害的机制进行分析。结果老年MM神经系统病变发生率为52.5%,病理性骨折、瘤块压迫、瘤细胞浸润或转移、严重贫血、高钙血症、尿毒症、淀粉样变性、高粘滞综合征、凝血障碍、免疫异常等均可成为神经系统损害的原因,发病机理主要为直接压迫、浸润转移、远隔效应三大类。结论老年MM患者神经系统病变发生率较一般MM患者高,神经系统损害的机制复杂多样;深入了解发病机制有助于认识疾病,减少误诊和漏诊。
Objective To explore the mechanism of nervous system damage in elderly patients with multiple myeloma (MM), including the causes and pathogenesis of nervous system diseases. Methods The clinical data of 21 elderly MM patients complicated by neurological damage were retrospectively analyzed. The mechanism of nervous system damage was analyzed according to the previous literature. Results The incidence of neurological diseases in elderly patients with MM was 52.5%. Pathological fractures, nodular compression, tumor cell infiltration or metastasis, severe anemia, hypercalcemia, uremia, amyloidosis, hyperviscosity syndrome, coagulopathy, Immune abnormalities can become the cause of nervous system damage, the pathogenesis mainly for direct oppression, invasion and metastasis, remote effect three categories. Conclusion The incidence of neurological diseases in elderly patients with MM is higher than that of normal patients with MM. The mechanism of nervous system damage is complex and diverse. A thorough understanding of the pathogenesis can help to understand the disease and reduce the misdiagnosis and missed diagnosis.