摘要
目的探讨琼脂糖凝胶血清蛋白电泳(AGE)在M蛋白相关性疾病中的临床诊断价值。方法对江苏省徐州市第一人民医院门诊及住院患者532例采用琼脂糖凝胶电泳法做AGE,对检出M蛋白带的43例样本,先做免疫固定电泳分型,再做免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)测定、尿本-周氏蛋白定量试验、红细胞沉降率、尿蛋白电泳、血生化钙磷以及蛋白的测定等实验室检查,分析AGE对M蛋白相关疾病的诊断意义。结果 43例在AGE中出现不同位置的M蛋白带,结合其临床表现,诊断出多发性骨髓瘤(MM)39例,巨球蛋白血症3例,POEMS综合征1例。其中39例MM患者中大于或等于54岁者居多(32例),男性略多于女性(23∶16)。IgG类MM所占比例最高(58.10%),IgM类MM最低(4.20%)。对骨髓瘤的诊断,电泳出现M蛋白带的阳性率为91.9%,总蛋白大于85g/L,占71.7%,球蛋白大于40g/L,占87.1%,本-周氏蛋白定量试验阳性率76.9%,红细胞沉降率增快,占100%,lgG升高者占89.2%。尿蛋白电泳中发现M蛋白阳性率79.4%。结论 AGE有助于M蛋白相关疾病的筛查、鉴别和诊断。
Objective To discuss the clinical diagnosis value of M-protein-related disease by agarose gel electrophoresis. Methods 532 patients in the first peoples＇ hospital of Xuzhou were detected by agarose gel electrophoresis,Then 43 samples of M protein band were conducted for Bence-Jones qualitative protein test,immunoglobulin tests of IgG,IgAand IgM,test of erythrocyte sedimentation rate, urinary protein electrophoresis and biochemical analyzer of Calcium ion and Phosphorous ion. And then the clinical diagnosis value of M-protein-related disease by serum protein electrophoresis was evaluated. Results Out of the 532 samples,43 of them showed unique protein bands. With further clinical diagnosis,39 of the 43 patients suffered Multiple Myeloma（MM）, 3 of them got macroglatulin, 1 of them got POEMS syndrome. Among the 39 MM patients,32 people were over 54 years old. And the amount of male patients was a little larger than that of the female patients（23.. 16）. IgG type MM took the highest ratio（58.1%） while the IgM type MM took the lowest（4.2%）. During the diagnosis of the patients,it found that 91.9% of the patients＇ serum protein electrophoresis showed positive in M protein band. And it also noticed that the total protein concentration was higher than 85 g/L in 71.7% of the patients＇ blood and the concentration of globulin was higher than 40g/L in 87.1% patients＇ blood. 76.9% of the patients＇ Bence-Jones tests showed positive. And 89.2% patients＇ blood test showed that the amount of IgG improved. Besides the test on the patients showed all of them had high ESR. And the SPE showed positively in 79.4 % of all the cases. Conclusion AGE does help the diagnosis of M protein-related diseases.
出处
《检验医学与临床》
CAS
2012年第24期3083-3084,3087,共3页
Laboratory Medicine and Clinic
关键词
血清蛋白电泳
M蛋白
多发性骨髓瘤
免疫球蛋白定量
serum protein electrophoresis
M protein multiple myeloma quantitative test of immunoglobulin
