血清游离轻链κ/λ比值在慢性肾病患者肾损伤中的诊断价值  

Diagnosis value of serum free light chain kappa/lambda ratio in kidney damage of patients with chronic kidney disease

作　　者：莫其农[1] 何进才[1] 宋林立[1] 冯玉丽[1] 余文辉[1] 袁敏[1] 李春花[1] 

机构地区：[1]广州中医药大学附属深圳市中医院检验科,广东深圳518033

出　　处：《国际检验医学杂志》2014年第2期161-162,164,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨血清游离轻链κ/λ比值(sFLC)在慢性肾病(CKD)患者肾损伤中的诊断价值。方法根据血清免疫固定电泳(IFE)结果和免疫透射比浊法测定血清游离轻链κ/λ比值,将95例慢性肾病患者分为3组:κ轻链阳性组(A组)30例;λ轻链阳性组(B组)30例;慢性肾功能不全对照组(C组)34例。另选取30例健康体检者作为对照组(D组)。用免疫透射比浊法检测血清中胱抑素C(Cys C)、C反应蛋白(CRP)、游离轻链κ和λ浓度水平及尿液中β2微球蛋白(β2-MG)、微量清蛋白(MA)和24小时尿总蛋白(24hPRO)水平;酶法检测血清肌酐(CREA)和尿液中N-乙酰-β-D葡萄糖苷酶(NAG)活性。结果 A组、B组和C组血清CREA、CRP、Cys C及尿液MA、β2-M、24hPRO浓度水平和NAG活性均增高,与D组比较,差异有统计学意义(P<0.01)。A组和B组血清CRP、Cys C及尿液MA、β2-MG、24hPRO浓度水平和NAG活性高于C组,差异有统计学意义(P<0.01)。结论血清游离轻链κ/λ比值检测在CKD患者肾损伤程度评估中具有重要的临床意义。Objective To evaluate the clinical value of serum free light chain kappa/lambda ratio （sFLC） in kidney damage of patients with chronic kidney disease （CKD）. Methods According to the results of serum immune fixation electrophoresis （IFE） and serum free light chain κ/λ ratio, 95 cases of patients with chronic kidney disease were divided into three groups： kappa light chain predominate positive group （group A） 30 eases,lambda light chain positive group of 31 cases （group B） ,chronic renal insuffi- ciency in the control group （C group） 34 cases and 30 cases of healthy physical examination were selected as control group （group D）. Immunological transmission turbidimetry was used to detect serum cystatin C （Cys C）, C-reactive protein（CRP）, free blight chain kappa and lambda concentration levels, urine beta 2 microglobulin （β2-MG）, trace albumin （MA） and 24 h urinary total pro tein （24 h PRO） contents, serum creatinine （CREA） and urine N-acetylq3-D glycosidase enzymes （NAG） activity were detected by enzymatic method. Results The serum CREA,CRP,Cys C and urine MA,β2-MG,24 h PRO concentration levels and NAG activity of group A,group B and group C were obviously higher than those of group D. Compared with group D,the difference was statisti- cally significant （P〈0.01）. The serum CRP, Cys C and urine MA,β2-MG, 24 h PRO concentration levels and NAG activity of group A and group B were obviously higher than those of group C. The difference was statistically significant （P〈0.01）. Conclu- sion The measurement of serum free light chain kappa/lambda ratio in renal damage degree evaluation for patients with chronic kidney disease （CKD） has important clinical significance.

关 键 词：免疫球蛋白轻链 肾疾病 半胱氨酸蛋白酶抑制剂 散射测浊法和比浊法 

分 类 号：R692[医药卫生—泌尿科学]