【摘要】 目的 探讨血清免疫固定电泳(IFE)、蛋白电泳(SPE)和免疫球蛋白定量在多发性骨髓瘤(MM)诊断中的作用。方法 选择2012年6月~2013年12月北京积水潭医院符合MM诊断标准的MM患者192例为研究对象,选择同期健康体检者30例为对照组,对MM患者进行免疫固定电泳、血清蛋白电泳和免疫球蛋白及轻链定量检测并对结果进行分析。结果 192例MM患者有120例血清蛋白电泳检出M带,检出率为62.5%;免疫固定电泳174例检出M带,检出率为90.6%;分型结果显示以IgG型最多(106例,55.2%),其中IgG-λ型66例(34.4%);IgA型次之(36例,18.8%),轻链型最低(24例,12.5%)。免疫球蛋白、轻链定量测定结果显示,在各型MM患者血清中出现相应免疫球蛋白及轻链的变化,与正常对照组比较差异具有统计学意义(P<0.05),检出率为67.7%(130/192)。无论是κ型还是λ型M蛋白,κ/λ比值均具有明显差异(P<0.05),检出率为85.4%(164/192)。结论 免疫固定电泳、免疫球蛋白及轻链定量、κ/λ比值测定等免疫学检测在MM诊断中有较好的检出率,能及时为临床提供有效的诊疗指标,减少误诊和漏诊的发生率。更多还原

【Abstract】 Objective To study the effectiveness of the laboratory diagnosis of multiple myeloma(MM) patients with immunofixtion electrophoresis(IFE),protein electrophoresis(SPE) and immunoglobulins and light chain quantitative analysis.Methods Selected 192 MM patients and 30 healthy controls during June 2012 to December 2013 and analyzed the results of IFE,SPE and immunoglobulins,and light chain quantitative analysis in MM patients.Results M protein bands were seen in120 cases(62.5%) by using SPE and M protein were positive in 174 cases(90.6%) among the 192 MM patients by using IFE.IFE showed that IgG were maximum type of the M protein(106 of 192,55.2%).There were IgG-X type 66 cases(34.4%),IgA type 36 cases(18.8%) and free light chain type 24 cases(12.5%).Immunoglobulins of different immunophenotypes had higher than the nomal group with serum immunoglobulin and light chain quantitative analysis(P<0.05).The detection rate was 67.7%(130/192).Whatever K-type M protein or X-type M protein,the ratio of κ/λ was significantly abnormal(P<0.05).The detection rate was 85.4%(164/192).Conclusion The better detection rate of immunological techniques such as immunofixtion electrophoresis and immunoglobulins quantitative analysis might provide valuable basis for the diagnosis and treatment of MM clinically and prevent misdiagnosis.更多还原