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目的探讨血液净化治疗多发性骨髓瘤合并急性肾损伤的疗效。方法选取2010年6月至2016年6月间山东省临朐县人民医院收治的90例多发性骨髓瘤合并急性肾损伤患者,采用随机数字表法分为观察组与对照组,每组45例,观察组患者在化疗基础上加用血液净化治疗,对照组患者给予化疗,对比两组患者临床疗效、生化指标及不良反应。结果观察组患者临床总有效率为84.4%,对照组患者总有效率为55.6%,两组比较差异有统计学意义(P<0.05)。观察组治疗后血清尿素氮(BUN)、肌酐(Cr)、β_2-微球蛋白(β_2-MG)和胱抑素C(CysC)水平分别为(5.74±2.11)mmol/L、(73.21±10.99)μmol/L、(1.70±0.36)mg/L和(0.58±0.15)mg/′L,低于对照组患者的BUN(6.23±1.56)mmol/L、Cr(89.63±15.42)μmol/L、β_2-MG(2.89±0.58)mg/L和CysC(1.39±0.78)mg/L,且两组患者治疗后BUN、Cr、β_2-MG和CysC四者水平与治疗前相比均降低,差异均有统计学意义(均P<0.05)。结论血液净化治疗多发性骨髓瘤合并急性肾损伤效果显著,能够降低肾脏损伤程度,安全性较高。
Objective To investigate the curative effect of blood purification on multiple myeloma with acute renal injury. Methods From June 2010 to June 2016, 90 patients with multiple myeloma with acute renal injury admitted to Lintao People’s Hospital of Shandong Province were divided into observation group and control group by random number table method, with 45 cases in each group. Patients in the observation group were treated with blood purification on the basis of chemotherapy, and patients in the control group were given chemotherapy. The clinical efficacy, biochemical indexes and adverse reactions were compared between the two groups. Results The total clinical effective rate was 84.4% in the observation group and 55.6% in the control group. The difference between the two groups was statistically significant (P <0.05). The levels of BUN, Cr, β_2-MG and CysC in the observation group were (5.74 ± 2.11) mmol / L, (73.21 ± 10.99) (6.23 ± 1.56) mmol / L and (89.63 ± 15.42) μmol / L, respectively, compared with the control group (P <0.01) β_2-MG (2.89 ± 0.58) mg / L and CysC (1.39 ± 0.78) mg / L, and the levels of BUN, Cr, β_2-MG and CysC in the two groups after treatment were lower than those before treatment, There was statistical significance (all P <0.05). Conclusions Blood purification treatment of multiple myeloma with acute renal injury significantly, can reduce the degree of renal damage, high safety.