多发性骨髓瘤相关肾损害的危险因素

摘要

Objective:To investigate the risk factors of multiple myeloma with renal damage.Methods:To retro-spectively analyze the clinical data of 89 cases of multiple myeloma patients.All patients were divided into group A, 57 cases with normal renal function and group B,32 cases with renal damage.Results:Univariate analysis showed that Hgb,blood Ca,blood P,blood URIC,serum 2 -MG,urinary Bence Jones protein,light chain type,infection and renal toxicity were risk factors(P <0.05).Multivariate logistic regression analysis showed that blood Ca,the type of light chain and Hgb were into the regression model(P <0.05).Conclusion:The renal damage is the main manifestation in patients with multiple myeloma.Hypercalcemia,monoclonal immunoglobulin free light chain type and anemia were in-dependent risk factors of multiple myeloma patients with renal impairment.%目的：分析多发性骨髓瘤相关肾损害的危险因素。方法：回顾性分析2009年1月－2013年12月我院收治的多发性骨髓瘤89例患者资料。将患者分为 A 组（肾功能正常）57例，B 组（肾功能损害）32例，各因素首先采取单因素分析，对具有统计学意义的因素进一步采取非条件多因素 Logistic 回归分析。结果：单因素分析显示，两组患者 Hgb、血 Ca、血 P、血 URIC、血清β2－MG、尿本周氏蛋白、轻链类型、感染以及肾毒性药物九个因素比较，差异具有统计学意义（P ＜0．05）。对上述单因素具有统计学意义的八个因素进行多因素Logistic 回归分析，血 Ca、轻链类型以及 Hgb 三个因素进入回归模型（P ＜0．05）。结论：肾损害是多发性骨髓瘤患者的主要表现，高血钙、单克隆免疫球蛋白游离轻链类型以及贫血是多发性骨髓瘤患者发生相关性肾损害的独立危险因素。