162例单克隆丙种球蛋白病血清及尿液κ、λ轻链水平测定的临床意义

Measurement of Levels of Light Chain κ,λ in Serum and Urine and Its Clinical S ignificance in 162 Patients with Monoclonal Gammopathy

目的 :观察良、恶性单克隆丙种球蛋白病血清及尿液中κ、λ轻链水平和κ/λ比率变化及其临床意义。方法 :以散射浊度法检测 1 6 2例各类单克隆丙种球蛋白病患者血清及部分尿液Ｉｇ、κ、λ轻链含量 ,并计算κ/λ比率。结果 :1 52例ＭＭＧＩｇ水平均显著减低 ,κ型κ/λ比率为 5. 3～ 493 ;λ型κ/λ比率为 0 . 0 0 6～ 0 . 2 3。 1 0例ＢＭＧ及 3 2例多克隆高丙种球蛋白血症患者κ/λ比率接近正常人。 1 7例ＢＪＰ型中仅 4例血清轻链明显升高且蛋白电泳谱出现Ｍ带 ,而 1 7例尿蛋白电泳谱均出现单一的轻链型Ｍ带。结论 :血清及尿液κ、λ定量和κ/λ比率对ＢＭＧ与ＭＭＧ、轻链病。

To obserue the changes on the level of light chain an d the ratio of κ,λ in the serum and urine from patients suffering in benign an d malignant monoclonal gammopathy,according to the Tesults the clinical signific ance were analyzed.Method: Total 162 cases were examined by the rate scatter nephel ometry and the κ/λ ratio was calculated.Results: The Ig level of 152 cases with MMG decreased significan tly,compared with control group.The κ/λ ratio in κ subtype was 5.3～493;in λ subtype was 0.006～0.23.The are 4 out of 17 cases of BJP showing significant in crease of serum light chain,while the urine protein electrophoresis all showed o ne M band of light chain.Conclusion: The quantities of κ and λ light chain in the serum and urine of patients with monoclonal gammopathy and their κ/λ ratio are sign ificant in the diagnosis and differential diagnosis in BMG,MMG,light chain disea se,monoclonal and polyclonal hyper gammaglobuliemia.