多发性骨髓瘤患者血清Cys-C、Urea、Scr及β_2-MG水平检测及其临床意义

Detection of Levels of Serum Cys-C,Urea,Scr and β_2-MG in Patients with Multiple Myeloma and Their Clinical Significance

目的分析多发性骨髓瘤(MM)患者血清胱抑素C(Cys-C)、尿素(Urea)、肌酐(Scr)及β_2微球蛋白(β_2-MG)水平及其临床意义。方法以2013年5月至2018年5月期间我院血液科收治的96例MM患者为研究对象,为MM组,ISS分期包括Ⅰ期28例、Ⅱ期42例、Ⅲ期26例;选取入院体检的健康志愿者30例作为对照组。均采集静脉血标本,检测血清Cys-C、Urea、Scr及β_2-MG水平,并根据肾小球滤过率(eGFR)诊断肾损害情况,分析四项指标诊断MM肾损伤的价值。结果与对照组相比,MM组血清Cys-C、Urea、Scr及β_2-MG水平显著升高(P<0.05)。MM组患者中,eGFR值Ⅰ期>Ⅱ期>Ⅲ期,血清Cys-C、Urea、Scr及β_2-MG水平Ⅰ期<Ⅱ期<Ⅲ期,差异有统计学意义(P <0.05)。MM患者eGFR值与血清Cys-C、Urea、Scr及β_2-MG水平呈负相关(r=-0.84,-0.39,-0.66,-0.47,P<0.05)。96例MM患者中,eGFR<90mL/(min·1.73m^2)者45例(46.88%)。伴肾损伤的MM患者血清Cys-C、Urea、Scr及β_2-MG阳性率明显高于不伴肾损伤者,且四项指标联合检测的阳性率显著高于不伴肾损伤者,差异有统计学意义(P <0.05)。四项指标中,Cys-C单独诊断MM肾损伤的灵敏度最高,达86.67%;而血清Cys-C、Urea、Scr及β_2-MG联合诊断MM肾损伤的灵敏度高达97. 78%。结论血清Cys-C、Urea、Scr及β_2-MG升高可反映MM病情情况,联合检测可提高肾功能损伤的诊断效能。

Objective To analyze the levels of serum cystatin C(Cys-C),urea,creatinine(Scr)andβ2-microglobulin(β2-MG)in patients with multiple myeloma(MM)and their clinical significances.Methods A total of 96 patients with MM admitted to the department of hematology of the hospital during the period from May 2013 to May 2018 were included in the MM group.According to the ISS stages,there were 28 cases of stage I,42 cases of stage II and 26 cases of stage III among these patients.30 healthy volunteers were also selected as the control group.Venous blood samples were collected in all patients to detect levels of serum Cys-C,urea,Scr andβ2-MG.Renal damage was diagnosed according to the glomerular filtration rate(eGFR),and the value of these four indicators for the diagnosis of MM with renal damage was then evaluated.Results Compared with the control group,the levels of Cys-C,urea,Scr andβ2-MG were significantly higher in the MM group(P<0.05).In the MM group,the eGFR values showed the pattern as:stage I>stage II>stage III,while levels of serum Cys-C,urea,Scr andβ2-MG showed the pattern as:stageⅠ<stageⅡ<stageⅢ(P<0.05).The eGFR value was negatively correlated with levels of serum Cys-C,urea,Scr andβ2-MG in MM patients(r=-0.84,-0.39,-0.66,-0.47,P<0.05).Among 96 MM patients,45 cases(46.88%)had eGFR value less than 90mL/(min·1.73m^2).The positive rates of serum Cys-C,urea,Scr andβ2-MG in patients with MM with renal damage were significantly higher than those in patients without renal damage,and the positive rate of combined detection of the four indicators was significantly higher than that in patients without renal damage(P<0.05).Among the four indicators,the sensitivity of Cys-C alone in the diagnosis of MM with renal damage was the highest,reaching 86.67%,while the sensitivity of combined detection of the four indicators in the diagnosis of MM with renal damage was as high as 97.78%.Conclusion The elevated levels of serum Cys-C,urea,Scr andβ2-MG can reflect the condition of MM,and combined detection of these 4 markers can improve the diagnostic efficiency of renal damage.