心肌炎患者血清免疫球蛋白游离轻链检测及其临床意义

Serum levels and clinical significance of immunoglobulin free light chain in myocarditis

目的了解心肌炎患者血清免疫球蛋白游离轻链(FLC)水平变化及其临床意义。方法采用免疫速率散射比浊法测定28例心肌炎患者(观察组)、20例健康成年人(对照组)血清FLC水平,通过ROC曲线法评估FLC对心肌炎的诊断效率,比较高低FLC水平患者中不良事件发生率。结果观察组λ型FLC水平高于对照组,而κ/λ比值低于对照组(P<0.01)。κ、λ型FLC及κ/λ比值的曲线下面积分别为0.318、0.747、0.153。κ/λ比值较高者不良事件少于较低者(P<0.05),而高低κ、λ型FLC水平者中不良事件差异无统计学意义(P>0.05)。结论心肌炎患者血清λ型FLC水平增高,κ/λ比值降低;FLC不宜作为心肌炎诊断指标;κ/λ比值降低者易发生不良事件。

Objective To investigate the serum levels and clinical significance of immunoglobulin free light chain(FLC) in myocarditis. Methods Serum FLC levels were determined by rate scattering immunoturbidimetry in 28 myocarditis patients(observation group) and 20 healthy adults(control group). Their diagnostic values of myocarditis were evaluated using ROC curve. The adverse events were compared between high and low FLC groups. Results Compared with control group, λ type was higher, while κ/λ ratio was lower in observation group(P<0.01). The area under curve of ROC was 0.318 for κ type, 0.747 for λ type, and 0.153 for κ/λ ratio. The adverse events were less in high κ/λ ratio than in low κ/λ ratio(P<0.05), but they were comparable between high and low levels of κ and λ type(P>0.05). Conclusion There are increased λ type and decreased κ/λ ratio in patients with myocarditis. FLC is unsuitable to serve as a diagnostic index for myocarditis. The low κ/λ ratio is associated with adverse events adverse events.