摘要
目的探讨血清学指标联合检测在多发性骨髓瘤(MM)患者肾损伤诊断中的应用价值。方法选择2021年1月—2022年3月广元市中心医院收治的110例MM患者作为研究对象,根据血肌酐(SCr)和血尿素氮(BUN)检测结果将患者分为MM组(30例;SCr<176.8 mmol/L和BUN<7.14 mmol/L)和MM肾损伤组(80例;SCr≥176.8 mmol/L和BUN≥7.14 mmol/L)。采集所有患者两份血清样本,一份使用全自动生化分析仪检测胱抑素C(Cys-C)、β2-微球蛋白(β2-M),另一份采用酶联免疫试剂盒检测白细胞介素-9(IL-9)、白细胞介素-17(IL-17);比较两组患者以及不同分期MM肾损伤患者上述指标水平,分析血清学指标在MM肾损伤患者中的诊断价值。结果MM肾损伤组的IL-9、IL-17、Cys-C、β2-M水平均明显高于对照组[IL-9(ng/L):92.15±5.26比52.36±2.15,IL-7(ng/L):72.15±6.24比40.52±3.35,Cys-C(mg/L):2.85±0.24比1.75±0.10,β2-M(mg/L):15.24±2.16比8.12±0.36,均P<0.05]。Ⅲ期MM肾损伤患者的IL-9、IL-17、Cys-C、β2-M水平均明显高于Ⅱ期和Ⅰ期患者[IL-9(ng/L):94.58±4.26比91.45±3.65、88.45±2.15,IL-7(ng/L):75.45±6.11比72.12±1.16、70.85±3.12,Cys-C(mg/L):3.12±0.05比2.66±0.08、2.10±0.05,β2-M(mg/L):17.45±2.01比15.11±1.34、13.12±1.02,均P<0.05]。四项血清学指标联合检测的阳性检出率、敏感度、特异度、准确度均明显高于IL-9、IL-17与Cys-C、β2-M两项指标联合检测(阳性检出率:70.00%比65.45%、65.45%,敏感度:93.75%比77.50%、78.75%,特异度:93.33%比66.67%、70.00%,准确度:93.64%比74.55%、76.36%,均P<0.05)。结论在MM肾损伤患者的诊断中,IL-9、IL-17、Cys-C、β2-M四项指标联合检测能获得较准确的结果,通过分析血清学指标变化能有效评估MM患者是否存在肾损伤,随着肾损伤病情严重程度的加重,患者血清学指标升高。
Objective To investigate the application value of combined detection of serological indexes in the diagnosis of renal injury in multiple myeloma(MM)patients.Methods The 110 MM patients admitted in Guangyuan Central Hospital from January 2021 to March 2022 were selected as research objects.According to serum creatinine(SCr)and blood urea nitrogen(BUN)levels,they were divided into MM group(30 cases;SCr<176.8 mmol/L and BUN<7.14 mmol/L)and MM kidney injury group(80 cases;SCr≥176.8 mmol/L and BUN≥7.14 mmol/L).Two serum samples were collected,one for detection of cystatin C(Cys-C)andβ2-microglobulin(β2-M),the other one for detection of interleukin-9(IL-9)and interleukin-17(IL-17).The levels of serological indicators between two groups and different phases were compared and the diagnostic value of serological indexes in patients with MM kidney injury was analyzed.Results The levels of IL-9,IL-17,Cys-C andβ2-M in MM renal injury group were higher than those in control group[IL-9(ng/L):92.15±5.26 vs.52.36±2.15,IL-7(ng/L):72.15±6.24 vs.40.52±3.35,Cys-C(mg/L):2.85±0.24 vs.1.75±0.10,β2-M(mg/L):15.24±2.16 vs.8.12±0.36,all P<0.05].The levels of IL-9,IL-17,Cys-C andβ2-M in phaseⅢMM renal injury patients were higher than those in phaseⅡandⅠpatients[IL-9(ng/L):94.58±4.26 vs.91.45±3.65,88.45±2.15,IL-7(ng/L):75.45±6.11 vs.72.12±1.16,70.85±3.12,Cys-C(mg/L):3.12±0.05 vs.2.66±0.08,2.10±0.05,β2-M(mg/L):17.45±2.01 vs.15.11±1.34,13.12±1.02,all P<0.05].The positive detectable rate,sensitivity,specificity and accuracy of combination of four serological indicators were higher than those of combination of two indicators IL-9,IL-17 and Cys-C,β2-M(positive detectable rate:70.00%vs.65.45%,65.45%,sensitivity:93.75%vs.77.50%,78.75%,specificity:93.33%vs.66.67%,70.00%,accuracy:93.64%vs.74.55%,76.36%,all P<0.05].Conclusions In the diagnosis of MM renal injury patients,the combination of IL-9,IL-17,Cys-C andβ2-M could obtain accurate results,and the analysis of serological index changes could effectively distinguish MM patients with renal injury.With the aggravation of renal injury,the serological indexes of patients increased.
作者
贾雁文
Jia Yanwen(Department of Clinical Laboratory,Guangyuan Central Hospital,Guangyuan 628000,Sichuan,China)
出处
《实用检验医师杂志》
2023年第3期246-249,共4页
Chinese Journal of Clinical Pathologist
