【国际骨髓瘤关注月】得了多发性骨髓瘤，5个症状可要记清楚了
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3月是国际骨髓瘤关注月。多发性骨髓瘤在血液科中是较为<span style="color: black;">平常</span>的一种<span style="color: black;">疾患</span>，<span style="color: black;">其中</span>尤其是以中老年<span style="color: black;">病人</span>更为多见，我国<span style="color: black;">病人</span>发病的中位年龄为57岁，近年来发病年龄呈<span style="color: black;">青年</span>化趋势。据估计，在中国每10万人口的发病率约为每年一至十二点五。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/images01/20240315/c5d2a3ace38f4adb8b76a65a77b90d3e.jpeg" style="width: 50%; margin-bottom: 20px;"> </p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤对身体健康造<span style="color: black;">成为了</span>很大的威胁，<span style="color: black;">况且</span><span style="color: black;">由于</span><span style="color: black;">初期</span>症状不太<span style="color: black;">显著</span>，加上其发病后的症状和<span style="color: black;">有些</span>中老年<span style="color: black;">平常</span><span style="color: black;">疾患</span>的症状是比较<span style="color: black;">类似</span>的，<span style="color: black;">因此</span>很容易漏诊或误诊，在<span style="color: black;">看病</span><span style="color: black;">检测</span>的时候，可能<span style="color: black;">已然</span>被确诊为晚期了，给治疗带来比<span style="color: black;">很强</span>的困难。<span style="color: black;">因此</span>，<span style="color: black;">认识</span>多发性骨髓瘤的<span style="color: black;">初期</span>症状，<span style="color: black;">针对</span><span style="color: black;">提高</span>早诊是有<span style="color: black;">帮忙</span>的，能<span style="color: black;">即时</span>抓住<span style="color: black;">初期</span>治疗的时间。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/images01/20240315/6a6381018eae46ebbe4f680fd3c99625.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<h1 style="color: black; text-align: left; margin-bottom: 10px;"><strong style="color: blue;">多发性骨髓瘤五个症状表现要记牢</strong></h1>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">1、</span>不明<span style="color: black;">原由</span>的骨痛、腰痛</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">骨痛是多发性骨髓瘤的<span style="color: black;">重点</span>症状，大约有70%的<span style="color: black;">病人</span>均可<span style="color: black;">显现</span>，<span style="color: black;">病痛</span>部位以腰骶部多见，其次为胸骨、肋骨和其他部位，一<span style="color: black;">起始</span>可能是间歇性<span style="color: black;">病痛</span>，之后<span style="color: black;">逐步</span>演变为<span style="color: black;">连续</span>性剧痛，痛感在<span style="color: black;">病人</span>活动时有可能会加剧。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">2、</span>贫血、<span style="color: black;">流血</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在初诊多发性骨髓瘤中，<span style="color: black;">都数</span><span style="color: black;">病人</span>会<span style="color: black;">显现</span>贫血，<span style="color: black;">重点</span>表现出<span style="color: black;">头昏</span>乏力、脸色苍白的现象。随着<span style="color: black;">疾患</span>的<span style="color: black;">发展</span>，几乎所有<span style="color: black;">病人</span>均会<span style="color: black;">显现</span>贫血。<span style="color: black;">通常</span>认为，与肿瘤细胞、细胞因子和并发症等<span style="color: black;">原因</span><span style="color: black;">相关</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">3、</span>不明<span style="color: black;">原由</span>肾功能不全</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤<span style="color: black;">关联</span>的轻链和高血钙<span style="color: black;">能够</span>损害肾脏，大<span style="color: black;">大概</span>50%的<span style="color: black;">病人</span>会<span style="color: black;">显现</span>有蛋白尿、血尿等。随着病情<span style="color: black;">发展</span>，可能会发展为肾功能衰竭。<span style="color: black;">因此呢</span>，<span style="color: black;">病人</span>会<span style="color: black;">显现</span>一系列的并发症，<span style="color: black;">详细</span>表现为腰酸、浮肿、<span style="color: black;">泡泡</span>尿、夜尿<span style="color: black;">增加</span>或尿量减少等症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">4、</span>恶心呕吐</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">少许</span>初诊的多发性骨髓瘤<span style="color: black;">病人</span>可能以恶心、呕吐为发病初期的症状。骨髓瘤<span style="color: black;">关联</span>的肾功能不全、高钙血症、胃肠道淀粉样变性都可能<span style="color: black;">引起</span>恶心，<span style="color: black;">另外</span>化疗<span style="color: black;">药品</span>的胃肠道反应<span style="color: black;">亦</span>可<span style="color: black;">引起</span>恶心。<span style="color: black;">倘若</span><span style="color: black;">同期</span>伴有骨痛、贫血，更应该进行<span style="color: black;">相关</span>骨髓瘤的<span style="color: black;">检测</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">5、</span>各类感染</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因为</span>白细胞减少、正常免疫球蛋白减少、抗体分泌减少等<span style="color: black;">引起</span>机体抵抗力降低，多发性骨髓瘤的<span style="color: black;">病人</span>是非常容易<span style="color: black;">出现</span>如带状疱疹病毒感染、肺部感染、尿路感染等<span style="color: black;">各样</span>感染问题的，严重的<span style="color: black;">乃至</span>可能<span style="color: black;">引起</span>败血症。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q0.itc.cn/images01/20240315/c327d642411e46dc90c91239824a30a2.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">贫血、腰腿疼、肾功能<span style="color: black;">反常</span>等问题<span style="color: black;">出现</span>在中老年群体身上，这似乎并不是什么稀奇事，然而这些<span style="color: black;">平常</span>症状的<span style="color: black;">暗地里</span><span style="color: black;">隐匿</span>的可能是一种血液肿瘤--多发性骨髓瘤。多发性骨髓瘤的临床表现有<span style="color: black;">非常多</span>，在平时<span style="color: black;">意见</span>中老年群体要多多<span style="color: black;">重视</span>，当<span style="color: black;">发掘</span>有可疑或<span style="color: black;">类似</span>症状时，应在排除<span style="color: black;">平常</span><span style="color: black;">疾患</span>后，<span style="color: black;">思虑</span>多发性骨髓瘤的可能性。<span style="color: black;">另外</span>，<span style="color: black;">平常</span>生活中<span style="color: black;">亦</span>要避免<span style="color: black;">有些</span>如高磁辐射的这种环境，<span style="color: black;">即时</span>进行适量的体育<span style="color: black;">熬炼</span>，不熬夜，<span style="color: black;">恰当</span>膳食，这些<span style="color: black;">办法</span><span style="color: black;">没</span>论是<span style="color: black;">针对</span>骨髓瘤还是其他肿瘤的防治<span style="color: black;">来讲</span>都是<span style="color: black;">特别有</span>必要的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q8.itc.cn/images01/20240315/3cf603cb10ae4633a2716b9fa3ef62ca.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">近年来，随着新药<span style="color: black;">研发</span>，早<span style="color: black;">发掘</span>、早诊断，并进行规范化治疗，大<span style="color: black;">都数</span>多发性骨髓瘤患者都有望延长<span style="color: black;">存活</span>时间，<span style="color: black;">加强</span>生活质量。面对多发性骨髓瘤难以治愈容易复发，复发后<span style="color: black;">存活</span>质量较差等问题，<span style="color: black;">病人</span>可<span style="color: black;">思虑</span><span style="color: black;">选取</span>伊沙佐米、卡非佐米、泊马度胺、达雷妥尤单抗、塞利尼索等<span style="color: black;">药品</span>治疗，并<span style="color: black;">定时</span>复查，尽可能地<span style="color: black;">加强</span><span style="color: black;">存活</span>获益。<span style="color: black;">这里</span>提醒<span style="color: black;">大众</span>，千万不要抱着等一等、看一看的<span style="color: black;">心理</span>，直到症状严重时才去<span style="color: black;">看病</span>，贻误了合适的治疗<span style="color: black;">机会</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">参考文献：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">复旦大学<span style="color: black;">附庸</span>中山医院多发性骨髓瘤诊疗规范（v1.2019）2018;25(5):855-859.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中国多发性骨髓瘤创新<span style="color: black;">药品</span>可及性研性 <span style="color: black;">药物</span><span style="color: black;">评估</span> Drug Evaluation 2020 年 1 月 第 17 卷 第 1 期</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">樊娟.多发性骨髓瘤的病理生理及临床表现.山东医药,2001:51-52.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">中国医师协会血液科医师分会, 中华医学会血液学分会. 中国多发性骨髓瘤诊治指南（2022年修订） . 中华内科杂志, 2022, 61(5) : 480-487.</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">程祝强,刘红军,金毅.以腰腿痛为首发症状的多发性骨髓瘤.中国<span style="color: black;">病痛</span>医学杂志,2018:637-638.</p>
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感谢楼主的分享！我学到了很多。
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