不同年龄组多发性骨髓瘤患者的骨损表现

目的：观察不同年龄组多发性骨髓瘤患者的骨损临床表现以及预后.方法：将本院70例多发性骨髓瘤患者按年龄分成＜65岁和≥65岁2组，观察骨损表现形式（溶骨性损害、广泛的骨质疏松）、发生部位（颅骨、颈椎、胸肋骨、腰骶椎、骨盆、四肢长骨）、高钙血症和骨损的关系以及相关预后、骨损和血β2-微球蛋白（β2-MG）的关系.结果：≥65岁组溶骨性损害发生率要高于＜65岁组.前者溶骨性损害常见部位是颅骨和胸肋骨;后者常见部位是腰椎和胸肋骨.并发高钙血症的老年患者预后可能较差.＜65岁组β2-MG异常患者中，非骨痛起病者预后好于骨痛起病者.结论：骨损表现及其相关预后指标在不同年龄组多发性骨髓瘤患者中意义不同。

Bone lesions in multiple myeloma patients of different age groups

Objective:To observe clinical features and prognostic factors of bone lesions in multiple myeloma patients of different age groups.Method:We analyzed 70 multiple myeloma patients diagnosed in our hospital who were divided into over 65 year old group and less than 65 year old group. To detect clinical features of bone lesions (osteolytic and diffuse osteoporosis lesions); different bones (cranial, cervical vertebrae, thoracic vertebrae and rib, lumbar ane sacrum, pelvis, long bones); the correlations and prognosis between hypercalcemia and bone lesions; the correlations between beta2-microglobulin in blood and bone lesions.Result:Lytic bone lesions occur more in over 65 year old patients. lytic bone lesions often occur in cranial, thoracic vertebrae and rib in 65 year older patients, and lumber, thoracic vertebrae and rib in less than 65 year old patients. The prognosis of patients with hypercalcemia may be worse. In less than 65 year old patients with abnormal beta2-microgolbulin in blood, the survival time in patients without bone pain is longer than patients with bone pain.Conclusion:In myeloma patients of different ages, the clinical features and relatively prognostic factors of bone lesions have different significance.