胱抑素C、α_(1)-微球蛋白及尿微量白蛋白单独及联合检测对多发性骨髓瘤合并肾损伤的诊断价值

Diagnostic value of cystatin C,α_(1)-microglobulin,and urinary microalbumin-single and combined detection in multiple myeloma with renal injury

目的胱抑素C(Cys-C)、α_(1)-微球蛋白(α_(1)-MG)及尿微量白蛋白(UMA)单独及联合检测对多发性骨髓瘤(MM)合并肾损伤的诊断价值。方法依据肾损伤情况将113例MM患者分为损伤组(n=36)和未损伤组(n=77),比较两组患者及不同肾损伤类型MM合并肾损伤患者的Cys-C、α_(1)-MG及UMA水平。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估Cys-C、α_(1)-MG及UMA单独及联合检测对MM合并肾损伤的诊断价值。结果未损伤组患者Cys-C、α_(1)-MG及UMA水平均明显低于损伤组,差异均有统计学意义(P﹤0.01)。肾衰竭型MM患者Cys-C、α_(1)-MG及UMA水平均明显高于肾病综合征型患者,差异均有统计学意义(P﹤0.01)。Cys-C、α_(1)-MG及UMA联合检测诊断MM合并肾损伤的AUC为0.804(95%CI:0.733~0.876),灵敏度为0.889,特异度为0.909,均高于三者单独检测。结论MM合并肾损伤患者Cys-C、α_(1)-MG及UMA水平较高,三者联合检测诊断MM合并肾损伤的价值较高。

Objective To investigate the diagnostic value of cystatin C(Cys-C),α1-microglobulin(α1-MG),and urinary microalbumin(UMA)single and combined detection in multiple myeloma(MM)with renal injury.Method A total of 113 MM patients were selected and divided into injury group(n=36)and non-injury group(n=77)based on renal injury status.The levels of Cys-C,α1-MG,and UMA were compared between the two groups and different types of MM patients combined with renal injury.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the Cys-C,α1-MG,and UMA single and combined detection in diagnosing MM combined with renal injury were evaluated.Result The Cys-C,α1-MG,and UMA levels in the non-injury group were significantly lower than those in the injury group,and the differences were statistically significant(P<0.01).The Cys-C,α1-MG,and UMA levels in MM patients with renal failure type were significantly higher than those in nephrotic syndrome type patients,and the differences were statistically significant(P<0.01).The AUC of Cys-C,α1-MG,and UMA combined detection in diagnosing MM combined with renal injury was 0.804(95%CI:0.733-0.876),the sensitivity was 0.889,and the specificity was 0.909,all of which were higher than those of single detection.Conclusion The Cys-C,α1-MG,and UMA levels are high in MM patients combined with renal injury,and the combined detection of the three has higher value in diagnosing MM combined with renal injury.