m5k1umn 发表于 2024-6-23 14:57:27

多发性骨髓瘤初期症状有哪些?——血液病专家曾英坚科普系列


    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">你<span style="color: black;">晓得</span>吗,<span style="color: black;">非常多</span>病人,尿检<span style="color: black;">表示</span>有蛋白尿,以为得了肾病,经过一系列肾病<span style="color: black;">关联</span><span style="color: black;">检测</span>和治疗后,效果<span style="color: black;">欠好</span>,再进一步<span style="color: black;">检测</span><span style="color: black;">发掘</span>病人竟然是骨髓瘤!还有不少病人,因腰痛去看病,多被误认为是腰肌劳损、腰椎间盘<span style="color: black;">明显</span>等病症,但不久又<span style="color: black;">显现</span>其他症状,<span style="color: black;">乃至</span><span style="color: black;">显现</span>骨折,进一步<span style="color: black;">检测</span><span style="color: black;">发掘</span><span style="color: black;">亦</span>竟然是骨髓瘤!什么是多发性髓瘤?多发性骨髓瘤都有哪些症状呢?</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">骨髓瘤是起源于骨髓造血组织、浆细胞过度增生<span style="color: black;">导致</span>的恶性肿瘤,<span style="color: black;">因为</span>其产生多发性骨损害,故<span style="color: black;">亦</span><span style="color: black;">叫作</span>为多发性骨髓瘤,<span style="color: black;">反常</span>的浆细胞浸润骨骼和软组织,产生M球蛋白<span style="color: black;">导致</span>骨骼破坏、贫血、肾功能<span style="color: black;">损害</span>和免疫功能<span style="color: black;">反常</span>,<span style="color: black;">平常</span>于中老年人。</p>
    <div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-a5c715ff4cba485497e37fc5f82aee7f_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">​</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤都有<span style="color: black;">那些</span>症状呢?</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(1)骨骼<span style="color: black;">病痛</span>:<span style="color: black;">由于</span>多发性骨髓瘤容易<span style="color: black;">导致</span>骨质破坏,所以骨痛是最为<span style="color: black;">重点</span>的症状,<span style="color: black;">病痛</span>最多见在腰骶部,<span style="color: black;">初期</span>可能是腰部,部分到后期<span style="color: black;">亦</span><span style="color: black;">能够</span>是胸肋部和下肢及全身的骨骼<span style="color: black;">病痛</span>。<span style="color: black;">倘若</span><span style="color: black;">病痛</span><span style="color: black;">尤其</span>剧烈<span style="color: black;">或</span><span style="color: black;">忽然</span>加重,说明很可能是<span style="color: black;">出现</span>了病理性骨折。做X线<span style="color: black;">检测</span><span style="color: black;">能够</span><span style="color: black;">发掘</span><span style="color: black;">显著</span>的骨质破坏和骨折线。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(2)贫血:贫血是另一个多发性骨髓瘤<span style="color: black;">平常</span>的表现,这是<span style="color: black;">由于</span>骨髓瘤的肿瘤细胞会<span style="color: black;">控制</span>正常的造血细胞功能。<span style="color: black;">初期</span>贫血<span style="color: black;">出现</span>缓慢,症状不<span style="color: black;">显著</span>,多为轻度或中度贫血,<span style="color: black;">大都是</span>做实验室<span style="color: black;">检测</span><span style="color: black;">发掘</span>。<span style="color: black;">倘若</span>贫血严重者,可能会有乏力、眩晕、耳鸣、失眠等贫血的表现。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(3)肾脏受到损害:多发性骨髓瘤时会合成<span style="color: black;">海量</span>M蛋白和轻链,<span style="color: black;">经过</span>相应机制都会使肾脏受到<span style="color: black;">损害</span>,可能<span style="color: black;">显现</span>蛋白尿、血尿、管型尿和急性或慢性肾衰竭。除此之外,肾损害可能<span style="color: black;">亦</span><span style="color: black;">由于</span><span style="color: black;">疾患</span><span style="color: black;">关联</span>的高钙血症、尿酸<span style="color: black;">太多</span>和淀粉样变性<span style="color: black;">相关</span>。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(4)高钙血症:骨髓瘤细胞会<span style="color: black;">导致</span>骨质的溶骨性损害,溶骨<span style="color: black;">出现</span>后钙离子<span style="color: black;">海量</span>进入血液,会<span style="color: black;">导致</span>高钙血症。轻微者<span style="color: black;">无</span><span style="color: black;">显著</span>不适,严重者<span style="color: black;">重点</span>表现为食欲缺乏、呕吐、乏力、<span style="color: black;">认识</span>模糊等,严重者危及生命。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(5)容易<span style="color: black;">出现</span>感染:<span style="color: black;">由于</span>多发性骨髓瘤使得正常的多克隆免疫球蛋白和中性粒细胞减少,免疫力下降,<span style="color: black;">因此</span>容易<span style="color: black;">出现</span><span style="color: black;">各样</span>感染,<span style="color: black;">例如</span>细菌性肺炎(咳嗽,咳痰,胸闷气喘)和尿路感染(尿频,尿急,尿痛),<span style="color: black;">乃至</span><span style="color: black;">出现</span>严重的败血症(发热,<span style="color: black;">晕倒</span>,<span style="color: black;">乃至</span>死亡)。还可能发<span style="color: black;">患病</span>毒感染,如带状疱疹等。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(6)高粘滞<span style="color: black;">综合症</span>:高粘滞血症是<span style="color: black;">由于</span>肿瘤细胞产生<span style="color: black;">非常多</span><span style="color: black;">反常</span>球蛋白,让血液变得粘稠,流动缓慢。<span style="color: black;">重点</span>表现为<span style="color: black;">头昏</span>、眩晕、眼花、耳鸣、手指麻木、视力<span style="color: black;">阻碍</span>、<span style="color: black;">认识</span><span style="color: black;">阻碍</span><span style="color: black;">乃至</span><span style="color: black;">晕倒</span>等。有的<span style="color: black;">病人</span>还可能<span style="color: black;">显现</span>雷诺现象:表现为间歇性手指皮色改变,呈现四肢末端皮肤颜色间歇性苍白、发绀和潮红。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(7)容易<span style="color: black;">流血</span>:病人很可能<span style="color: black;">显现</span>鼻腔<span style="color: black;">流血</span>,牙龈<span style="color: black;">流血</span>,<span style="color: black;">况且</span>止血困难。<span style="color: black;">另一</span>皮肤紫癜<span style="color: black;">亦</span>多见,表现是身上有红色、紫色的小斑点,严重的有大块的紫红斑块。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(8)淀粉样变性:<span style="color: black;">少许</span>的病人会<span style="color: black;">出现</span>不同程度的淀粉样变性,表现是舌头、腮腺肿大,腹泻或便秘,皮肤苔藓样改变,心肌会肥厚,心脏会扩大,严重的会<span style="color: black;">出现</span>猝死。有可能<span style="color: black;">出现</span>外周神经病变,<span style="color: black;">显现</span>肢体麻木,<span style="color: black;">反常</span>的<span style="color: black;">病痛</span>等。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">(9)神经系统损害:神经系统被累及的话,可能会<span style="color: black;">显现</span>肌肉<span style="color: black;">没</span>力,肢体麻木和痛觉迟钝。<span style="color: black;">倘若</span><span style="color: black;">出现</span>脊髓严重压迫,可能会使病人截瘫。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤的临床表现可谓是多种多样,不同的病人表现<span style="color: black;">亦</span>不<span style="color: black;">同样</span>,<span style="color: black;">各样</span>表现<span style="color: black;">显现</span>的时间<span style="color: black;">次序</span><span style="color: black;">亦</span>不<span style="color: black;">必定</span>,容易漏诊和误诊。<span style="color: black;">因此</span>,<span style="color: black;">倘若</span><span style="color: black;">显现</span>了上面的<span style="color: black;">有些</span>症状,<span style="color: black;">必须</span><span style="color: black;">加强</span><span style="color: black;">警觉</span>,尽早到医院进行<span style="color: black;">检测</span>和治疗,<span style="color: black;">以避免</span>延误病情、<span style="color: black;">错失</span>最佳治疗<span style="color: black;">机会</span>。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">专家介绍</p>




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