摘要
目的探讨肾功能指标检测在多发性骨髓瘤(MM)患者肾损伤诊断中的应用。方法选择2019年1月—2021年10月如东县人民医院收治的70例MM患者作为观察组,根据国际分期系统(ISS)将观察组患者分为Ⅰ期(22例)、Ⅱ期(36例)、Ⅲ期(12例);另外选择同期本院35名健康体检者作为对照组。采集两组受检者空腹静脉血,采用全自动生化分析仪检测血清胱抑素C(Cys-C)、尿素(Urea)、血肌酐(SCr)以及β_(2)微球蛋白(β_(2)-MG)水平,比较各组上述指标的差异,分析其对MM患者肾损伤的诊断价值。结果观察组Cys-C、Urea、SCr、β_(2)-MG水平均明显高于对照组〔Cys-C(mg/L):2.27±0.56比0.83±0.22,Urea(mmol/L):8.89±1.23比7.02±1.04,SCr(μmol/L):138.35±16.97比87.31±11.33,β_(2)-MG(mg/L):5.46±1.87比1.68±0.63,均P<0.05〕。不同病情严重程度MM患者的Cys-C、Urea、SCr、β_(2)-MG水平比较差异均有统计学意义,且随着病情程度的加重,患者的Cys-C、Urea、SCr、β_(2)-MG水平均逐渐升高,估算的肾小球滤过率(eGFR)逐渐降低,差异均有统计学意义。70例MM患者中,eGFR<90 mL/(min·1.73 m2)的患者数为34例(占48.57%)。MM合并肾损伤患者的Cys-C、Urea、SCr、β_(2)-MG以及四项指标联合检测的诊断阳性率均明显高于未合并肾损伤患者〔Cys-C:85.29%(29/34)比41.67%(15/36),Urea:67.65%(23/34)比22.22%(8/36),SCr:79.41%(27/34)比30.56%(11/36),β_(2)-MG:82.35%(28/34)比33.33%(12/36),四项指标联合:97.06%(33/34)比44.44%(16/36),均P<0.05〕;Cys-C、Urea、SCr、β_(2)-MG诊断MM合并肾损伤的敏感度分别为85.71%、70.00%、80.00%、81.43%,四项指标联合检测诊断MM合并肾损伤的敏感度最高(97.14%)。结论Cys-C、Urea、Scr、β_(2)-MG水平可反映MM患者的病情严重程度,且四项指标联合检测有助于MM患者肾损伤的诊断。
Objective To investigate the application of renal function indexes detection in diagnosis of renal injury in patients with multiple myeloma(MM).Methods A total of 70 patients with MM who were admitted in People's Hospital of Rudong County from January 2019 to October 2021 were selected as the observation group,and according to the international staging system(ISS),the patients in the observation group were divided into stageⅠ(22 cases),stageⅡ(36 cases)and stageⅢ(12 cases).Other 35 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.Fasting venous blood samples were collected from both groups,and the levels of serum cystatin C(Cys-C),Urea,serum creatinine(SCr)andβ_(2)microglobulin(β_(2)-MG)were detected by automatic biochemical analyzer.The differences of the above indexes in each group were compared,and the diagnostic values for renal injury in MM patients were analyzed.Results The levels of Cys-C,Urea,SCr andβ_(2)-MG in the observation group were significantly higher than those in the control group[Cys-C(mg/L):2.27±0.56 vs.0.83±0.22,Urea(mmol/L):8.89±1.23 vs.7.02±1.04,SCr(μmol/L):138.35±16.97 vs.87.31±11.33,β_(2)-MG(mg/L):5.46±1.87 vs.1.68±0.63,all P<0.05].The levels of Cys-C,Urea,SCr andβ_(2)-MG in MM patients with different severities were with statistically significant differences;with the aggravation of the disease,the levels of Cys-C,Urea,SCr andβ_(2)-MG gradually increased,and the estimated glomerular filtration rate(eGFR)gradually decreased,the differences were statistically significant.Among 70 patients with MM,there were 34 cases(accounting for 48.57%)of patients with eGFR<90 mL/(min·1.73 m2).The positive rates of Cys-C,Urea,SCr,β_(2)-MG and the combined detection of four indexes in patients with MM complicated with renal injury were significantly higher than those in patients without renal injury[Cys-C:85.29%(29/34)vs.41.67%(15/36),Urea:67.65%(23/34)vs.22.22%(8/36),SCr:79.41%(27/34)vs.30.56%(11/36),β_(2)-MG:82.35%(28/34)vs.33.33%(12/36),combination of four indexes:97.06%(33/34)vs.44.44%(16/36),all P<0.05].The sensitivities of Cys-C,Urea,SCr andβ_(2)-MG in the diagnosis of MM complicated with renal injury were 85.71%,70.00%,80.00%and 81.43%,respectively.The sensitivity of combined detection of four indexes in the diagnosis of MM complicated with renal injury was the highest(97.14%).Conclusion The levels of Cys-C,Urea,SCr andβ_(2)-MG could reflect the severity of the disease in patients with MM,and the combined detection of the four indexes is helpful for the diagnosis of renal injury in patients with MM.
作者
翟海军
Zhai Haijun(Department of Clinical Laboratory,People's Hospital of Rudong County,Nantong 226400,Jiangsu,China)
出处
《实用检验医师杂志》
2022年第1期47-50,共4页
Chinese Journal of Clinical Pathologist
