血清胱抑素C、尿α_1-微球蛋白在多发性骨髓瘤患者早期肾损害的临床意义
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摘要
目的探讨血清胱抑素C(Cys-c)、尿α1-微球蛋白(α1-MG)在多发性骨髓瘤(MM)患者早期肾损害的临床意义。方法测定110例多发性骨髓瘤患者血清Cys-C、尿α1-MG、血肌酐、血清β2-微球蛋白(β2-MG)水平,与对照组80例健康体检者比较。结果肾功正常的多发性骨髓瘤患者血清Cys-C、尿α1-MG水平明显高于健康对照组(P<0.01),血清Cys-C、尿α1-MG与β2-MG呈正相关,P<0.05。ISS-Ⅲ期多发性骨髓瘤病人血清Cys-C明显高于ISS-Ⅰ期和ISS-Ⅱ期。结论血清Cys-C、尿α1-MG可作为监测MM肾损害的早期指标、其敏感性和特异性优于血肌酐,且血清Cys-C、尿α1-MG是反映多发性骨髓瘤的肿瘤负荷、判断预后重要指标之一。Cys-C是多发性骨髓瘤分期的重要指标之一。
Objective: To investigate the clillical significance of serum cystatin C,urinary α1-microglobulin( α1-MG) in multiple myeloma( MM) patients with early renal damage. Methods: Serum level of Cys-C,urinary α1- microglobulin,serum creatinine( cr) and serum beta 2 micmglohuli In( β2-MG) were measured in the 110 MM patients as the research group.Twenty cases from healthy physical examination were used as the control group. Results: Serum Cys-C andα1-MG level were much higher in normal renal function MM group than those of the control group( P < 0. 01). Expression level of serum CysC andα1-MG had a positive correlation with the expression level ofβ2-MG( P < 0. 05). Serum Cys-C level was much higher in ISS-Ⅲ phase MM group than that of ISS-Ⅰ and ISS-Ⅱ phase MM group( P < 0. 05). Conclusion: Serum Cys-C and α1-MG are considered as diagnostic markers for early renal function impairment,and are better than Cr in reflecting tumor burden and providing prognostic information in MM.
Objective: To investigate the clillical significance of serum cystatin C,urinary α1-microglobulin( α1-MG) in multiple myeloma( MM) patients with early renal damage. Methods: Serum level of Cys-C,urinary α1- microglobulin,serum creatinine( cr) and serum beta 2 micmglohuli In( β2-MG) were measured in the 110 MM patients as the research group.Twenty cases from healthy physical examination were used as the control group. Results: Serum Cys-C andα1-MG level were much higher in normal renal function MM group than those of the control group( P < 0. 01). Expression level of serum CysC andα1-MG had a positive correlation with the expression level ofβ2-MG( P < 0. 05). Serum Cys-C level was much higher in ISS-Ⅲ phase MM group than that of ISS-Ⅰ and ISS-Ⅱ phase MM group( P < 0. 05). Conclusion: Serum Cys-C and α1-MG are considered as diagnostic markers for early renal function impairment,and are better than Cr in reflecting tumor burden and providing prognostic information in MM.
引文
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[11]钱瑛,陈文,吴国荣,等.血清胱抑素C、血清肌酐在多发性骨髓瘤肾损害中的效能比较[J].中国实验诊断学,2012,16(1):129-130.
[12]岑海燕,施文瑜,徐梦麒,等.多发性骨髓瘤患者血清β2微球蛋白和乳酸脱氢酶水平及其临床意义[J].中国医师进修杂志,2013,36(4):28-30.
[13]王英,罗晓红,劳伟思,等.多发性骨髓瘤患者β2-微球蛋白测定的临床意义[J].中国热带医学,2007,7(2):248-249.
[14]ELEUTHERAKIS-PAPAIAKOVOU V,BAMIAS A,GIKA D,et al.Renal failure in multiple myeloma:incidence,correlations,and prognostic significance[J].Leuk lymphoma,2007,48(2):337-341.
[2]Kyle RA,Gertz MA,Witzig TE,et al.Review of 1027 patient with newly Diagnosed multiple myeloma[J].Mayo Clin Proc,2003,78:21-33.
[3]Terpos E,Katodritou E,Tsiftsakis E,et al.Cystatin-C is an independent prognostic factor for survival in multiple myeloma and is reduced by bortezomib administration[J].Haematologica,2009,94:372-379.
[4]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:232-235.
[5]中国医师协会血液科医师分会,中华医学会血液学分会,中国多发性骨髓瘤工作组.中国多发性骨髓瘤诊治指南(2013年修订)[J].中华内科杂志,2013,30(8):791-792.
[6]邹剑峰.多发性骨髓瘤的肾损害的发病机制及防治进展[J].国际输血及血液学杂志,2007,30(4):323.
[7]刘广勤,冯磊光.肾功能损害患者血清胱抑素C与肌酐的测定比较[J].齐齐哈尔医学院学报,2008,29(7):808-809.
[8]彭国进,朱华强.胱抑素C研究进展[J].现代医药卫生,2004,20(11):972.
[9]蔡钢强,垢敬.胱抑素C的生物学特性及临床应用评价[J].国际检验医学杂志,2006,27(5):457-460.
[10]黄琴,杨淑芬,李燕,等.血清胱抑素C在多发陛骨髓瘤预后中的意义[J].白血病·淋巴瘤,2014,23(4):213-215.
[11]钱瑛,陈文,吴国荣,等.血清胱抑素C、血清肌酐在多发性骨髓瘤肾损害中的效能比较[J].中国实验诊断学,2012,16(1):129-130.
[12]岑海燕,施文瑜,徐梦麒,等.多发性骨髓瘤患者血清β2微球蛋白和乳酸脱氢酶水平及其临床意义[J].中国医师进修杂志,2013,36(4):28-30.
[13]王英,罗晓红,劳伟思,等.多发性骨髓瘤患者β2-微球蛋白测定的临床意义[J].中国热带医学,2007,7(2):248-249.
[14]ELEUTHERAKIS-PAPAIAKOVOU V,BAMIAS A,GIKA D,et al.Renal failure in multiple myeloma:incidence,correlations,and prognostic significance[J].Leuk lymphoma,2007,48(2):337-341.