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血液科、肾内科和骨科新诊断多发性骨髓瘤住院患者的特征。

Characteristics of inpatients with newly diagnosed multiple myeloma in hematology, nephrology, and orthopedic departments.

机构信息

Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000, China.

Department of Clinical Laboratory, Taizhou Hospital, Zhejiang University, Linhai, 317000, China.

出版信息

Ann Hematol. 2023 Apr;102(4):801-809. doi: 10.1007/s00277-023-05115-7. Epub 2023 Feb 8.

Abstract

To describe the characteristics of multiple myeloma (MM) by retrospectively analyzing data from patients with MM in hematology, nephrology, and orthopedic departments, we selected inpatients diagnosed with MM for the first time who were admitted to the hematology department of Taizhou Hospital of Zhejiang Province between January 1, 2017, and June 30, 2021 ([Formula: see text]) and those admitted to the nephrology ([Formula: see text]) and orthopedic ([Formula: see text]) departments of Taizhou Hospital of Zhejiang Province between January 1, 2010, and June 30, 2021. For patients with MM initially diagnosed in the nephrology or orthopedic departments, age- and sex-matched patients without MM were randomly selected in a 1:1 ratio. Conditional logistic regression models were used to assess the risk of MM in hospitalized patients in the nephrology and orthopedic departments. This study included 200 patients, with a median age of 65 years. There were differences among patients in the three departments with respect to fracture, degree of anemia, proteinuria levels, red blood cell (RBC) count, hemoglobin levels, total protein (TP) levels, albumin levels, and laboratory indicators of renal function. TP levels > 68.45 g/L were independent risk factors for patients in the nephrology department (odds ratio (OR) = 1.01, 95% confidence interval (CI) = 1.001-1.024, P = 0.04), and RBC count < 3.79 × 10/L was an independent risk factor for orthopedic inpatients (OR = 0.49, 95% CI 0.268-0.913, P = 0.02). Therefore, nephrologists should pay attention to the TP level of hospitalized patients to facilitate the early identification of MM in patients with chronic kidney disease. Orthopedic surgeons should pay attention to RBC counts in patients with fractures, and patients with low RBC counts should avoid unnecessary surgery and move to specialist care as early as possible.

摘要

为了通过回顾性分析血液科、肾内科和骨科住院的多发性骨髓瘤(MM)患者的数据来描述 MM 的特征,我们选择了 2021 年 1 月 1 日至 6 月 30 日期间首次在浙江省台州医院血液科确诊为 MM 的住院患者([公式:见正文]),以及 2010 年 1 月 1 日至 2021 年 6 月 30 日期间在浙江省台州医院肾内科和骨科住院的患者。对于在肾内科或骨科首次诊断为 MM 的患者,按照年龄和性别 1:1 随机选择无 MM 的患者。使用条件 logistic 回归模型评估肾内科和骨科住院患者发生 MM 的风险。本研究共纳入 200 例患者,中位年龄为 65 岁。这三组患者在骨折、贫血程度、蛋白尿水平、红细胞计数(RBC)、血红蛋白水平、总蛋白(TP)水平、白蛋白水平和肾功能实验室指标方面存在差异。TP 水平>68.45 g/L 是肾内科患者的独立危险因素(比值比(OR)=1.01,95%置信区间(CI)=1.001-1.024,P=0.04),RBC 计数<3.79×10/L 是骨科住院患者的独立危险因素(OR=0.49,95%CI 0.268-0.913,P=0.02)。因此,肾内科医生应注意住院患者的 TP 水平,以便及早识别慢性肾脏病患者的 MM。骨科医生应注意骨折患者的 RBC 计数,RBC 计数低的患者应避免不必要的手术,并尽早转至专科治疗。

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