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肾功能指标联合检测对多发性骨髓瘤肾功能不全诊断价值的分析 预览

Diagnostic value of combined detection of renal function biomarkers in multiple myeloma with renal insufficiency
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摘要 目的探讨肾功能指标联合检测对多发性骨髓瘤(MM)肾功能不全的诊断价值。方法对192例明确诊断的MM患者的肾功能检测指标[肌酐(SCr)、24小时尿蛋白(24hPro)、尿素氮(BUN)、血尿酸(UA)、白蛋白(ALB)、血β2微球蛋白(β2-MG)、尿kappa轻链(uKAP)、尿lambda轻链(uLAM)]进行分析。比较血清SCr+轻链蛋白尿+24hPro联合诊断和SCr单项诊断MM患者肾功能不全的检出率,以及经SCr+轻链蛋白尿+24hPro诊断为肾功能不全后,不同国际分期体系(ISS)分期的MM患者肾功能相关指标水平,并通过各检测指标的受试者工作特征曲线(简称ROC曲线)下面积评估其对MM肾功能不全的诊断价值。结果SCr+轻链蛋白尿+24hPro诊断肾功能不全的检出率为38.0%,明显高于单独SCr诊断的18.2%(P﹤0.01);不同ISS分期患者的年龄及ALB、β2-MG、24hPro、uKAP、u LAM、UA、BUN、SCr水平比较,差异均有统计学意义(P﹤0.05);根据各检测指标的ROC曲线下面积,24hPro诊断肾功能不全的价值最高,其次分别为SCr、BUN、β2-MG、uKAP、UA及uLAM(P﹤0.05)。结论在判断MM患者肾功能不全时,除检测BUN和SCr外,还应结合24hPro、uKAP、uLAM、UA、β2-MG等指标进行综合判断,以便对MM患者的肾功能状态做出准确的评估。 Objective To investigate the diagnostic value of combined detection of renal function biomarkers in multiple myeloma(MM)with renal insufficiency.Method A analysis was performed for 192 patients with clinically confirmed MM to detect their renal function biomarkers[serum creatinine(SCr),24-hour urine protein(24 hPro),blood urea nitrogen(BUN),blood uric acid(UA),albumin(ALB),bloodβ2 microglobulin(β2-MG),urine kappa light chain(uKAP),urine lambda light chain(uLAM)].The detection rate of renal insufficiency in MM patients using combined detection of SCr+light chains proteinuria+24 hPro and SCr alone was compared,besides,after the diagnosis of renal insufficiency by SCr+light chain proteinuria+24 hPro,the renal function biomarker levels among MM patients classified using varying international stating system(ISS)were determined,and the receiver operating characteristic curve(ROC)of each marker was detected to assess the diagnostic value for renal insufficiency in MM patients.Result The combined detection of SCr+light chain proteinuria+24 h Pro had a detection rate of 38.0%,which was significantly higher than that of SCr alone at 18.2%(P<0.01);among patients with different ISS stage,there were significant differences regarding age,ALB,β2-MG,24 hPro,uKAP,uLAM,UA,BUN,and SCr,and there was statistical significance noted(P<0.05).According to the area under ROC curve,24 hPro showed the highest diagnostic value for diagnosing renal insufficiency,followed by SCr,BUN,β2-MG,uKAP,UA and u LAM(P<0.05).Conclusion When diagnosing renal insufficiency in MM patients,in addition to BUN and SCr,24 hPro,uKAP,uLAM,UA,andβ2-MG should also be comprehensively considered,so as to make an accurate assessment of the renal function of MM patients.
作者 汤然 赵祎 钟玉萍 任占宝 李晓阳 王金英 TANG Ran;ZHAO Yi;ZHONG Yuping;REN Zhanbao;LI Xiaoyang;WANG Jinying(Department of 1Haematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China;Clinical Laboratory, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100043, China)
出处 《癌症进展》 2019年第11期1335-1337,1360共4页 Oncology Progress
关键词 多发性骨髓瘤 肾功能不全 联合检测 multiple myeloma renal insufficiency combined detection
作者简介 通信作者:王金英,邮箱:13641281894@163.com.
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