血清免疫球蛋白及轻链定量测定在多发性骨髓瘤病情监测中的应用

The Application of Quantitative Detection of Serum Immunoglobulin and Light Chain in Multiple Myeloma Condition Monitoring

目的通过对多发性骨髓瘤患者血清免疫球蛋白及轻链定量测定结果变化的动态分析,以评价治疗效果。方法对25例IgG-Kappa型多发性骨髓瘤患者在2008-2014年不同发展阶段中的血清IgG、Kappa定量测定及血清蛋白电泳、免疫固定电泳结果进行统计,结合患者不同治疗阶段的疗效,遴选出四个主要时期(初发、移植前有效、复发、移植后有效)的结果并进行统计学分析。结果初发组、复发组、移植前有效组和移植后有效组的M蛋白平均含量分别为(35.67±8.49)%、(18.08±7.02)%、(8.43±7.94)%、(3.05±2.96)%。25例移植前有效组和8例移植后有效组的M蛋白含量为0的及免疫固定电泳未见IgG、Kappa区带的分别都占20%、50%。初发和复发组的IgG、Kappa,相比正常对照组升高有统计学意义(P<0.001),移植前有效组Kappa相比正常对照组升高有统计学意义(P<0.05)。移植前有效组IgG及移植后有效组IgG、Kappa,相比正常对照组升高无统计学意义(P>0.05)。移植后有效组IgG、Kappa轻链定量结果相比移植前有效组的更低于其他两组,疗效最佳。结论血清免疫球蛋白及轻链定期的测定为临床治疗多发性骨髓瘤患者提供可靠的依据,在患者病情监测和疗效评价中起到重要的作用。

Objective Making a dynamic analysis of the results of quantitative detection of serum immunoglobulin and light chain？in patients with multiple myeloma to evaluate the effect of the treatment.Methods Make a statistics of the results of serum immunoglobulin including IgG and Kappa,serum protein electrophoresis（SPE）and immunofixation electrophoresis（IFE）of 25IgG-Kappapatients with multiple myeloma in the different stages of development from2008 to 2014,in combination with the curative effect of patients with different stages of treatment,select four major periods（early,effective before transplantation,recurrence,effective after transplantation）of results and make a statistical analysis on them.Results The average content of M protein of early,effective before transplantation,recurrence and effective after transplantation groups by using SPE were respectively（35.67±8.49）%,（18.08±7.02）%,（8.43±7.94）%,（3.05±2.96）%.In 25 cases of effective group before transplantation and 8cases of effective group after transplantation,Both M protein content and not seen IgG-Kappa zone by using IFE were respectively 20%,50%.Compared with normal control group,Kappa of early and recurrence groups were higher and there were with statistical significance（P〈0.001）,Kappa of effective group before transplantation were higher and there was with statistical significance（P〈0.05）.IgG of effective group before transplantation,IgG and Kappa of effective group after transplantation,were higher and there were no significant difference（P〉0.05）.Compared with effective group before transplantation,IgG and Kappa light chain quantitative results of effective group after transplantation were more lower than other two groups,the curative effect is best.Conclusion The test of serum immunoglobulin and light chain regularly can provide reliable basis for clinical treatment of multiple myeloma patients,and play an important role in the patient condition monitoring and assessment of curative effect.