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为检知骨髓瘤伴存严重肾衰竭患者加强治疗的效果和评估肾活检的意义,作者回顾分析了16例骨髓瘤患者的治疗经验。14例患者作了肾活俭:11例为骨髓癌管型肾病,其中2例伴有高血压肾病;2例为轻链沉淀病;1例为间质性肾炎。9例初发症状为尿毒症表现,7例表现为肺炎、骨痛、肺气肿和缺血性心脏病。7例患者采用标准剂量马法兰治疗,剂量随肾衰竭程度而调整。9例采用长春新硷、阿霉素和甲基强的松龙(VAMP)方案治疗,后组中5例达部
In order to examine the effect of intensive treatment in patients with myeloma with severe renal failure and to assess the significance of renal biopsy, the authors reviewed the experience of treatment in 16 patients with myeloma. Fourteen patients underwent renal thromboprophylaxis: 11 were tubulointerstitial nephropathy, 2 with hypertensive nephropathy; 2 with light-chain sediment disease; and 1 with interstitial nephritis. 9 cases of initial symptoms of uremia performance, 7 cases showed pneumonia, bone pain, emphysema and ischemic heart disease. Seven patients were treated with standard-dose melphalan and the dose was adjusted with the extent of renal failure. Nine patients were treated with vincristine, doxorubicin and methylprednisolone (VAMP). In the latter group,