尿NAG联合血清β2-MG、Cys-C对多发性骨髓瘤患者肾功能损伤的预测价值

Predictive Value of Urinary NAG Combined with Serumβ2-MG and Cystatin C in Renal Function Damage of Patients with Multiple Myeloma

目的探讨尿N-乙酰-β-氨基葡萄糖苷酶(n-acetyl-beta-d-glucosidase,NAG)联合血清β2-微球蛋白(β2-microglobulin,β2-MG)、胱抑素-C(cystatin-C,Cys-C)对多发性骨髓瘤(multiple myeloma,MM)患者肾功能损伤的预测价值。方法收集MM 116例,根据肾功能损伤情况将其分为肾功能损伤组(45例)和肾功能正常组(71例)两组。比较两组一般资料和实验室指标,采用Logistic回归分析对影响MM患者肾功能损伤的相关因素进行分析,采用受试者工作特征(ROC)曲线分析尿NAG联合血清β2-MG、Cys-C对MM患者肾功能损伤的预测价值。结果肾功能损伤组国际分期系统(international staging system,ISS)分期、尿NAG及血清β2-MG、Cys-C、肌酐(creatinine,Cr)高于肾功能正常组,血红蛋白低于肾功能正常组,差异均有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,ISS分期Ⅲ期、尿NAG≥2.37 U/mmol及血清β2-MG≥6.3 mg/L、Cys-C≥0.98 mg/L、Cr≥135μmol/L为MM患者肾功能损伤的危险因素(P<0.05)。ROC曲线分析结果显示,尿NAG和血清β2-MG、Cys-C、Cr预测MM患者肾功能损伤的曲线下面积(AUC)依次为0.812、0.808、0.813和0.745;尿NAG联合血清β2-MG、Cys-C预测MM患者肾功能损伤的AUC为0.894。结论尿NAG联合血清β2-MG、Cys-C对MM患者肾功能损伤具有较高预测价值。

Objective To analyze the predictive value of urinary n-acetyl-beta-d-glucosidase(NAG)combined with serumβ2 microglobulin(β2-MG)and cystatin C(Cys-C)in evaluating renal function damage of patients with multiple myeloma(MM).Methods A total of 116 patients with MM were enrolled and divided into renal function damage group(n=45)and normal renal function group(n=71)according to their renal function damage.The general data and laboratory indicators of patients in two groups were compared.Logistic regression analysis was performed to analyze factors related to renal function damage in MM patients.ROC curve was performed to analyze predictive value of urine NAG,serumβ2-MG and Cys-C for renal function damage in MM patients.Results The international staging system(ISS)staging,urine NAG,serumβ2-MG,Cys-C and creatinine(Cr)in renal function damage group were higher than those in normal renal function group,while hemoglobin was lower than that in normal renal function group(P<0.05 or P<0.01).The results of multivariate Logistic regression analysis showed that ISS stageⅢ,urine NAG≥2.37 U/mmol,serumβ2-MG≥6.3 mg/L,Cys-c≥0.98 mg/L,and Cr≥135μmol/L were risk factors for renal function damage in MM patients(P<0.05).The results of ROC curve analysis showed that the AUC of urine NAG,serumβ2-MG,Cys-C and Cr for renal function in MM patients were 0.812,0.808,0.813,0.745,respectively.The AUC of NAG combined with serumβ2-MG and Cys-c for renal function in MM patients was 0.894.Conclusion Urine NAG combined with serumβ2-MG and Cys-c have higher predictive value for renal function damage in MM patients.