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目的探讨多发性骨髓瘤 (MM)误诊与实验检查的关系。方法MM及正常人血清分别以原血清及 1∶4稀释后用速率散射比浊法测IgG值 ;MM及正常人尿液分成 3份测本周蛋白 ,A管 ,尿用pH4 9醋酸缓冲液酸化 ,置 5 6℃水浴 15min ,B管不加缓冲液 ;C管置水浴 7～ 8min。结果 2 0例MM未稀释血清IgG16 .8± 6 94 (g/L) ;1∶4稀释血清IgG35 .89± 11 88(g/L) ,P <0 0 1;A组尿本周蛋白的阳性率 5 1 5 % ,B组及C组分别为 2 1 2 %及 2 4 2 % ,P <0 0 5。结论MM血清未稀释形成后带现象及尿本周蛋白定性操作不规范是导致MM误诊的重要原因。
Objective To explore the relationship between misdiagnosis and experimental examination in multiple myeloma (MM). Methods The MM and normal human serum were diluted with the original serum and 1:4 respectively. The IgG values were measured by rate nephelometry. The urine of MM and normal humans were divided into 3 samples to measure weekly protein, A tube, and urinary pH 49 buffer solution. Acidification, set 5 6 °C water bath 15min, B tube without buffer; C tube set water bath 7 ~ 8min. Results 20 cases of MM undiluted serum IgG16. 8± 664 (g/L); 1 ∶ 4 dilution of serum IgG35.89±11 88 (g/L), P <0 01; A group of urine protein The positive rate was 5 15%. The B group and C group were 2 1 2% and 2 4 2% respectively, P <0 05. Conclusion The undetermined formation of postmenopausal MM serum and the non-standard quaternary protein characterization are important reasons for the misdiagnosis of MM.