血清游离轻链比值在心肌淀粉样变性诊断中的应用价值探讨

Application value of serum free light chain ratio in diagnosis of myocardial amyloidosis

目的探讨血清游离轻链比值在心肌淀粉样变性诊断中的应用价值。方法选取该院2015年1月至2018年11月住院患者43例,根据临床诊断将患者分为病例组20例,对照组23例。收集患者入院资料及相关临床检验诊断数据并进行分析。结果病例组与对照组肾功能及心肌标志物水平比较,差异无统计学意义(P>0.05)。血清蛋白电泳诊断心肌淀粉样变性的灵敏度为55.00%,特异度为91.30%;免疫固定电泳诊断心肌淀粉样变性的灵敏度为50.00%,特异度为87.00%;血清游离轻链比值诊断心肌淀粉样变性的灵敏度为90.00%,特异度为78.26%。血清游离轻链比值联合血清蛋白电泳、免疫固定电泳应用于临床较单独应用血清游离轻链比值不能提供更好的诊断性能和价值。结论血清游离轻链比值在筛查和诊断心肌淀粉样变性中有较好的临床应用价值和前景。

Objective To explore the value of serum free light chain ratio in the diagnosis of myocardial amyloidosis.Methods A total of 43 hospitalized patients in the hospital from January 2015 to November 2018 were selected.According to the clinical diagnosis,the patients were divided into case group(20 cases)and control group(23 cases).Patients admission baseline data and relevant clinical pathology data were collected.Results There was no significant difference in renal function and myocardial marker levels between case group and control group(P>0.05).The sensitivity of serum protein electrophoresis in diagnosing myocardial amyloidosis was 55.00%,and the specificity was 91.30%;the sensitivity of immunofixation electrophoresis in diagnosing myocardial amyloidosis was 50.00%,and the specificity was 87.00%;the sensitivity of serum free light chain ratio in diagnosing myocardial amyloidosis was 90.00%,and the specificity was 78.26%.The serum free light chain ratio combined with serum protein electrophoresis and serum immunofixation electrophoresis used in clinical applications could not provide better diagnostic performance and value than the free light chain ratio alone.Conclusion Serum free light chain ratio has good clinical application value and prospects in screening and diagnosing myocardial amyloidosis.