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目的:探讨轻链型多发性骨髓瘤肾脏损害原因和鉴别诊断要点。方法:对肾脏受累的轻链型多发性骨髓瘤患者生化检验、组织病理、X线检查及临床资料进行回顾性分析。结果:轻链型多发性骨髓瘤可有溶骨病变、贫血、肾损害。血清高钙、低免疫球蛋白,血、尿轻链比值异常等。乳粒增强免疫比浊法检测免疫球蛋白可对多发性骨髓瘤分型。结论:提高对该病的认识,准确鉴定血、尿蛋白免疫球蛋白成分,及时进行X线与骨髓象检查,可减少误诊。
Objective: To investigate the causes of renal damage in light chain multiple myeloma and its differential diagnosis. Methods: The biochemical tests, histopathology, X-ray examination and clinical data of patients with light chain multiple myeloma with renal involvement were retrospectively analyzed. Results: Light chain multiple myeloma may have osteolytic lesions, anemia and renal damage. High serum calcium, low immunoglobulin, blood, urine light chain ratio abnormalities. Immunopotentiation of immunoglobulin with milk-enhanced immunoturbidimetry can classify multiple myeloma. Conclusion: To improve the understanding of the disease, accurately identify the blood and urine protein immunoglobulin components, timely X-ray and bone marrow imaging can reduce the misdiagnosis.