血清胱抑素C在多发性骨髓瘤肾功能损害诊断中的价值  

Diagnostic value of serum cystatin C in multiple myeloma with renal impairment

作　　者：黄大毛[1] 朱湘雅[2] 丘世飏[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008 [2]怀化医学高等专科学校医学检验系,2007级湖南怀化418000

出　　处：《中国现代医学杂志》2010年第11期1652-1655,1660,共5页China Journal of Modern Medicine

摘　　要：目的探讨血清胱抑素C(CysC)在诊断多发性骨髓瘤(MM)肾功能损害中的价值。方法用日立7170A全自动生化分析仪检测32例MM患者和20例健康体检者血清CysC、尿素(Urea)、肌酐(Cre)、尿酸(UA)及β2-微球蛋白(β2-MG)的含量。用受试者工作曲线(ROC)评价CysC的诊断价值。结果在新诊断的MM患者中,CysC含量(1.90±1.53)明显高于健康对照组(0.70±0.20)(P<0.05),并且与β2-MG成明显正相关(r=0.474,P<0.05)。受试者工作曲线(ROC)分析显示,CysC的曲线下面积(AUC)(0.903)高于β2-MG(0.881)、Cre(0.624)、Urea(0.636)和UA(0.770)。ISS-Ⅲ期MM中CysC(3.07±1.95)明显高于ISS-Ⅰ期(1.12±0.50)和ISS-Ⅱ期(1.32±0.48)(P<0.05)。结论 CysC可以作为诊断MM患者肾功能损害的敏感内源性指标之一,而且优于β2-MG、Urea、Cre和UA,在MM分期和判断预后中也有重要的临床意义。[Objective]To investigate the diagnostic value of serum cystatin C （Cys C） in renal impairment of multiple myeloma （MM）.[Methods]The levels of Cys C, creatinine （Cre）, urea, uric acid （UA） and β2-microglobu-lin （β2-MG） were detected in 32 cases of newly diagnosed MM and 20 cases of normal persons using Hitachi 7170A Automatic biochemical analyzer. Receiver operator characteristic （ROC） system evaluated the diagnostic value of Cys C in MM. [Results]The levels of Cys C in newly diagnostic MM group （1.90±1.53） were significantly higher than those in the normal group （0.70±0.20）（P 0.05）, Cys C was positively correlated with β2-MG （r = 0.474, P 0.05）. In receiver operator characteristic, the area under curve （AUC） of Cys C was higher than β2-MG （0.881）, Cre（0.624）, Urea（0.636） and UA（0.770）, the Cys C was the best. The levels of Cys C in MM with ISS stage III（3.07±1.95） were obviously higher than the ISS stage Ⅰ（1.12±0.50） and the ISS stage Ⅱ（1.32±0.48） （P 0.05）.[Conclusion]Serum Cys C can be used as a sensitive endogenous marker of renal impairment in MM, and is better than β2-MG, Urea, Cre and UA. It has important clinical significance in MM staging and predictive value in prognosis.

关 键 词：胱抑素C 多发性骨髓瘤 肾功能损害 

分 类 号：R551.3[医药卫生—血液循环系统疾病]