摘要
目的探讨血清游离轻链比值（serum free light chain ratio, rFLC）测定对鉴别骨髓瘤肾病致尿毒症的指导意义。方法采用免疫比浊法测定39例初诊为尿毒症患者的血清游离轻链值，根据其临床诊断分为多发性骨髓瘤致尿毒症组12例；非多发性骨髓瘤致尿毒症组27例；比较2组．c血清游离轻链（κ-sFLC）、x血清游离轻链（κ-sFLC）及rFLC的差异，并分析其相关性。结果多发性骨髓瘤致尿毒症患者κ-sFLC、λ—sFLC高于正常范围的比例分别为83．3％和66．6％；非多发性骨髓瘤致尿毒症患者k-sFLC、λ-sFLC高于正常范围的比例分别为96．3％和96．3％，无统计学差异（P〉0．05）；多发性骨髓瘤致尿毒症组rFLC均不在正常范围内，非多发性骨髓瘤致尿毒症组rFLC均在正常范围内，具有统计学差异（P〈0．05）。多发性骨髓瘤致尿毒症组κsFLC与λ-sFLC无显著相关性（P〉0．05）；非多发性骨髓瘤致尿毒症组κ-sFLC与λ-sFLC呈正相关（P〈0.01，r=0．675）。结论rFLC可以反映κsFLC和λsFLC是否是单克隆性增高，可以作为鉴别骨髓瘤肾病所致尿毒症的可靠指标。
Objective To explore the differential diagnostic value of the serum free light chain ratio （rFLC） for the uremia etiology. Methods Selected newly diagnosed uremia patients were divided into two groups according to their clinical diagnosis： 12 cases of multiple myeloma （MM） uremia and 27 case of non-MM uremia, κ-sFLCs, λ-sFLCs and the ratios （rFLC, κ/λ） were detected by using im- munology nephelometry assays, and their linear correlation was analyzed. Results In MM uremia group,83. 3% and 66. 6% had higher κ-sFLCs and λ-sFLCs levels than normal ones,and in non-MM uremia group, 96. 3% and 96. 3%, without significant difference between two groups （P〉0. 05）. rFLCs levels in MM uremia group were abnormal, while those in non-MM uremia group were normal, with significant difference between two groups （P〈0. 05）. There was no significant linear correlation （P〉0. 05） between k-sFLCs and λ-sFLCs in MM uremia group,while there was significantly positive linear correlation （r =0.675, P〈0. 01 ） in non-MM uremia group. Conclusions rFLC can reveal whether k-sFLC and λ-sFLC are monoclonal or not and it is a reliable differential diagnosis indicator for the uremia etiology.
出处
《临床肾脏病杂志》
2013年第5期202-204,共3页
Journal Of Clinical Nephrology
基金
湖北省自然科学基金（No：2011CDB211）
