生化指标联合检测对多发性骨髓瘤早期肾损伤的诊断价值

Diagnostic value of joint detection of biomarkers for the early renal impairment in multiple myeloma patients

目的探讨血清胱抑素C(Cys-C)、尿视黄醇结合蛋白(RBP)对多发性骨髓瘤(MM)患者早期肾损伤的诊断价值。方法根据肾小球滤过率估计值(eGFR)将MM患者分为两组:A组为肾功能正常组(eGFR≥90mL/min)78例;B组为肾功能损伤组(eGFR<90mL/min)40例。130例健康体检者作为对照组。检测并比较各组血清Cys-C、尿RBP、血清尿素氮(UN)、血清肌酐(Cr)水平。结果 A组MM患者Cys-C和RBP水平与对照组比较,差异有统计学意义(P<0.01),B组Cys-C、Cr、UN、尿RBP水平均显著高于对照组(P<0.01)。Cys-C和尿RBP联合检测的阳性率为57.69%,明显高于单项检测(P<0.05)。结论 CysC和RBP比传统指标能更有效地诊断MM患者早期肾损伤,联合检测具有重要价值。

Objective To discuss the diagnostic value of serum cystatin-C（Cys-C）and urinary retinol binding protein（RBP）for the early renal impairment in multiple myeloma（MM）patients.Methods According to estimated glomerular filtration rate（eGFR）,the MM patients were divided into two groups：the normal renal function group（eGFR≥90mL/min,n=78）marked group A,the renal impairment group（eGFR90mL/min,n=40）marked group B.130 healthy subjects were selected as control group.The concentrations of serum Cys-C,urinary RBP,serum creatinine（Cr）and serum urea nitrogen（UN）were measured and compared.Results The levels of Cys-C and RBP in group A were significantly higher than those in the control group（P〈0.01）.There were significant difference of the levels of Cys-C,Cr,UN and RBP levels between group B and control group（P〈0.01）.The sensitivity of the combined detection of Cys-C and RBP was 57.69%,significantly higher than single index test（P〈0.05）.Conclusion Compared with traditional biomarkers,Cys-C and RBP are more sensitive and effective indexes for the diagnosis of early renal impairment in the patients with MM,and jointed detection of the two biomarkers has important value.