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目的分析经白蛋白校正后血钙在多发性骨髓瘤患者中的应用及临床意义。方法选自我院收治初诊多发性骨髓瘤患者71例,测定其血钙浓度值、血清白蛋白值等。校正公式:校正血钙值(mmol/L)=血清总钙测定值(mmol/L)+(40-血清白蛋白测定值)×0.025(mmol/L)。以血肌酐<176.8μmol/L为A组;血肌酐>176.8μmol/L为B组。结果 71例多发性骨髓瘤患者血钙浓度为(2.31±0.45)mmol/L,校正后血钙浓度为(2.61±0.48)mmol/L,校正前后血钙浓度差异具有统计学意义(P<0.001)。高钙血症患者构成比由14.1%升至校正后的21.1%,低钙血症构成比由53.5%下降至校正后的15.5%,正常血钙组患者例数增加。A、B组患者之间血钙浓度校正前后均无统计学差异(P>0.05)。71例患者中位随访时间25个月。血钙浓度与溶骨部位多少及生存时间均无明显相关性。结论校正血钙值更好地反映疾病严重程度;高钙血症与肾功能不全存在相关性。
Objective To analyze the clinical application of serum albumin-corrected calcium in patients with multiple myeloma. Methods From our hospital, 71 patients with newly diagnosed multiple myeloma were enrolled and their serum calcium concentration and serum albumin were measured. Calibration formula: Calibrated serum calcium (mmol / L) = serum total calcium (mmol / L) + (40-serum albumin) × 0.025 (mmol / L). Serum creatinine <176.8μmol / L for the A group; serum creatinine> 176.8μmol / L for the B group. Results The serum calcium concentration was (2.31 ± 0.45) mmol / L in 71 patients with multiple myeloma and (2.61 ± 0.48) mmol / L after correction. The difference of serum calcium concentration before and after correction was statistically significant (P <0.001 ). The proportion of patients with hypercalcemia rose from 14.1% to 21.1% after correction, the proportion of hypocalcemia decreased from 53.5% to 15.5% after correction, and the number of patients with normal calcium increased. There was no significant difference between A and B groups before and after adjustment of serum calcium concentration (P> 0.05). The median follow-up time of 71 patients was 25 months. Calcium concentration and the number of osteolytic sites and survival time were not significantly correlated. Conclusions Corrected serum calcium values better reflect disease severity; hypercalcemia is associated with renal insufficiency.