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目的探讨多发性骨髓瘤并急性肾损伤患者进行血液净化疗法的临床效果。方法选取2013年6月至2014年6月间简阳市人民医院收治的42例多发性骨髓瘤并急性肾损伤患者,根据随机数字表法分为观察组和对照组,每组各21例。观察组患者采用血液净化+化疗法+急性肾损伤疗法,对照组患者采用化疗+急性肾损伤治疗,比较两组患者的临床效果;评估比较两组患者治疗前后的乳酸脱氢酶(LDH)、C反应蛋白、血清球蛋白和血沉等临床实验室指标情况;评估比较两组患者治疗前后的血清中尿素氮(BUN)、肌酐(Cr)、β_2-微球蛋白(β_2-MG)和胱抑素C(CysC)等临床指标情况。结果观察组患者的临床有效率为90.5%,对照组为57.1%,组间差异有统计学意义(P<0.05);两组患者治疗后LDH、C反应蛋白、血清球蛋白和血沉等临床指标均有改善,但观察组患者治疗后LDH、C反应蛋白、血清球蛋白和血沉指标显著优于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后血清中BUN、Cr、β_2-MG和CysC等临床指标均有改善,观察组患者治疗后血清中BUN、Cr、β_2-MG和CysC等临床指标显著高于对照组,差异均有统计学意义(P<0.05)。结论多发性骨髓瘤并急性肾损伤进行血液净化疗法,可显著改善患者的临床症状,降低肾损害程度,临床效果确切,值得临床推广。
Objective To investigate the clinical effect of blood purification in patients with multiple myeloma and acute kidney injury. Methods Forty-two patients with multiple myeloma and acute kidney injury who were treated in Jianyang People’s Hospital from June 2013 to June 2014 were divided into observation group and control group according to the random number table method, with 21 cases in each group. Patients in the observation group were treated with blood purification plus chemotherapy and acute kidney injury, while those in the control group were treated with chemotherapy and acute kidney injury. The clinical effects of the two groups were compared. Lactate dehydrogenase (LDH) C-reactive protein, serum globulin and erythrocyte sedimentation rate in clinical laboratory indicators; assessment of two groups of patients before and after treatment of serum urea nitrogen (BUN), creatinine (Cr), β_2-microglobulin C (CysC) and other clinical indicators of the situation. Results The clinical effective rate was 90.5% in the observation group and 57.1% in the control group, with significant difference between the two groups (P <0.05). The clinical indexes of LDH, C-reactive protein, serum globulin and erythrocyte sedimentation rate But the indexes of LDH, C-reactive protein, serum globulin and erythrocyte sedimentation rate in the observation group were significantly better than those in the control group, the difference was statistically significant (P <0.05). Serum levels of BUN, Cr, β_2-MG and CysC in both groups were improved after treatment. The clinical indexes of serum BUN, Cr, β_2-MG and CysC in the observation group were significantly higher than those in the control group after treatment There was statistical significance (P <0.05). Conclusion Multiple myeloma and acute renal injury for blood purification therapy can significantly improve the clinical symptoms of patients and reduce the degree of renal damage, the clinical effect is exact, worthy of clinical promotion.