目的:了解多发性骨髓瘤(MM)的临床特点,减少误诊、漏诊,并探讨实验室检查对MM的诊断意义。方法回顾性分析51例MM患者临床资料。结果:①40例MM被误诊,占78.4%。②骨痛和乏力是最常见首发症状,分别为21例(41.2%),18例(35.3%)。③51例MM分型以IgG型最多(26例,51.0%),其次为IgA型11例,轻链型10例。④49例MM免疫固定电泳检出M蛋白,其对应的免疫球蛋白(Ig)均有不同程度升高,而其他正常的Ig降低。⑤49例MM血清游离轻链κ/λ异常,并且存在比值失衡现象(即一种轻链升高,另一种轻链降低)。⑥51例MM骨髓检查均检出浆细胞。结论:MM的临床表现复杂,容易误诊;免疫固定电泳和骨髓穿刺检查是诊断MM的重要指标;Ig及游离轻链检测对诊断MM有筛查作用。 Objective: To understand the clinical features of multiple myeloma (MM), to reduce the misdiagnosis, missed diagnosis, and to explore the significance of laboratory tests in the diagnosis of MM. Methods The clinical data of 51 MM patients were retrospectively analyzed. Results: ①40 cases of MM were misdiagnosed, accounting for 78.4%. ② Pain and fatigue were the most common initial symptoms, which were 21 (41.2%) and 18 (35.3%) respectively. (3) The genotypes of 51 patients were IgG type (26 cases, 51.0%), followed by IgA type in 11 cases and light chain type in 10 cases. ④ The immunoglobulin (Ig) immunoglobulin (Ig) levels in 49 patients with MM immunostaining were all increased to some extent, while those in other normal Igs decreased. ⑤49 cases of MM serum free light chain κ / λ abnormalities, and there is imbalance ratio (ie, a light chain, the other light chain decreased). ⑥ 51 cases of MM bone marrow examination were detected in plasma cells. Conclusion: The clinical manifestations of MM are complex and easily misdiagnosed. Immuno-immobilized electrophoresis and bone marrow aspiration are important indicators in the diagnosis of MM. Ig and free light chain detection can be used to screen for the diagnosis of MM.