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对我院1981～1997年间收治的12例多发性骨髓瘤的肾损害患者进行分析,旨在进一步提高骨髓瘤肾病的认识。 1 临床资料 病例诊断符合国内多发性骨髓瘤诊断标准。其中男7例,女5例;年龄最小42岁,最大73岁,平均年龄58岁。 入院时蛋白尿10例,尿蛋白((?))9例,((?))1例,肾损害阳性率83％,同伴镜下血尿4例,血压增高3例,诊断慢性肾炎4例,肾病综合征1例,1例有口渴,多饮,多尿,夜尿增多已有2年,检查有尿K~+、Na~+、C1~-排泄增多的肾小管功能异常,4例蛋白尿原因不明。入院时尿素氮、肌酐异常7例,肾功能不全发生率58％,其中6例为慢性肾功能不全,1例为急性肾功能不全,后者存在肾盂肾炎和肺炎的感染诱因。6例慢性肾功能不全患者均有贫血,其中轻度贫血4例,中度贫血2例。入院时本病合并肾盂肾炎4例,肺炎3例,血钙大于2.7mmol/L4例。
The analysis of 12 patients with multiple myeloma renal lesions treated in our hospital from 1981 to 1997 was designed to further improve the understanding of myeloma nephropathy. 1 Clinical data Case diagnosis meets the diagnostic criteria for multiple myeloma in China. There were 7 males and 5 females; the youngest was 42 years old, and the oldest was 73 years old. The average age was 58 years old. 10 cases of proteinuria on admission, 9 cases of urinary protein ((?)), ((?)) 1 case, positive rate of renal damage 83%, 4 cases with histological hematuria, blood pressure increased in 3 cases, diagnosis of chronic nephritis in 4 cases, 1 case of nephrotic syndrome, 1 case of thirst, polydipsia, polyuria, nocturia increase for 2 years, examination of urinary K~+, Na~+, C1~~ excretion increased renal tubular dysfunction, 4 cases The cause of proteinuria is unknown. Urinary nitrogen and creatinine were abnormal in 7 patients on admission and the incidence of renal insufficiency was 58%. Among them, 6 patients had chronic renal insufficiency, 1 patient had acute renal insufficiency, and the latter had pyelonephritis and pneumonia infection causes. All 6 patients with chronic renal insufficiency had anemia, including 4 cases of mild anemia and 2 cases of moderate anemia. At the time of admission, 4 cases of pyelonephritis, 3 cases of pneumonia, and 4 cases of blood calcium were more than 2.7 mmol/L.