60岁以上人群血清游离κ轻链、游离λ轻链及二者比值参考区间的建立  

Establishment on the reference intervals of serum free κ light chain, free λ light chain and their ratio in the population over 60 years old

作　　者：李萍 吴炯[2] 潘柏申[2] LI Ping;WU Jiong;PAN Baishen(Shanghai Gumei Community Health Service Center,Shanghai 201102,China;Department of Clinical Laboratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海古美社区卫生服务中心,上海201102 [2]复旦大学附属中山医院检验科,上海200032

出　　处：《检验医学》2016年第12期1031-1035,共5页Laboratory Medicine

摘　　要：目的 初步建立上海地区60岁以上人群血清游离κ轻链和游离λ轻链及二者比值的参考区间。方法收集342名社区老年健康体检者（其中227名为参考区间建立队列，115名为参考区间验证队列）的基础流行病学数据（心血管疾病、肝病、肾病、糖尿病病史及药物史），同时测定血清游离κ轻链、游离λ轻链、总κ轻链、总λ轻链，并计算游离κ轻链/游离λ轻链比值（简称游离κ/λ比值），按性别和年龄分别分组并作比较。以双侧第2.5百分位和第97.5百分位建立参考区间，并观察验证队列在参考区间中的分布情况。结果 男性血红蛋白、肌酐及钙水平与女性比较，差异均有统计学意义（P<0.05），而不同性别、不同年龄段之间总κ轻链、总λ轻链、总κ轻链/总λ轻链比值（简称总κ/λ比值）、游离κ轻链、游离λ轻链及游离κ/λ比值差异均无统计学意义（P>0.05）。血清游离κ/λ比值与血红蛋白、肌酐、钙均无相关性（r=0.046、-0.071、0.054，P>0.05）。取双侧第2.5百分位数和第97.5百分位数得出血清游离κ轻链、游离λ轻链及游离κ/λ比值的参考区间分别为7.17～14.07mg/L、23.04～60.59mg/L、0.15～0.46。采用115名验证队列验证建立的参考区间，其中分别有95.65%（游离κ轻链）、95.65%（游离λ轻链）和96.52%（游离κ/λ比值）的人结果落在参考区间内。结论 研究建立了上海地区60岁以上人群游离κ轻链、游离λ轻链及游离κ/λ比值的参考区间。该参考区间在60岁以上社区老年健康人群中有较好的应用价值。Objective To establish the reference intervals of serum free kappa(κ) light chain,free lambda(λ) light chain and their ratio in the population over 60 years old. Methods Epidemiological data(the historiesof cardiovascular,hepatic,renal and diabetes mellitus diseases and pharmacohistory) were collected from 342elder healthy subjects(227 cases of derivation cohort and 115 cases of validation cohort) in communities. Serumfree κ light chain,free λ light chain,total κ light chain and total λ light chain were determined,and the ratio of freeκ light chain to free λ light chain(free κ/λ ratio) was calculated. The results were classified and analyzed accordingto sex and age. The bilateral 2.5th and 97.5th percentiles were used to establish reference intervals,and the validationcohort's distribution of free κ/λ ratio in reference intervals was evaluated. Results There was statistical significancefor hemoglobin,creatinine and calcium between males and females(P<0.05). There was no statistical significancefor total κ light chain,total λ light chain,the ratio of total κ light chain to total λ light chain(total κ/λ ratio),free κ light chain,free λ light chain and free κ/λ ratio between males and females with different ages(P>0.05).There was no correlation of free κ/λ ratio with hemoglobin,creatinine and calcium(r=0.046,-0.071 and 0.054,P>0.05). According to the bilateral 2.5th and 97.5th percentiles,the reference intervals of free κ light chain,free λ light chain and free κ/λ ratio were 7.17-14.07 mg/L,23.04-60.59 mg/L and 0.15-0.46. There were 95.65%,95.65%and 96.52% subjects' free κ light chain,free λ light chain and free κ/λ ratio in validation cohort within the above 3reference intervals. Conclusions The reference intervals of free κ light chain,free λ light chain and free κ/λ ratio inthe population over 60 years old have been established,which can be used in the population over 60 years old.

关 键 词：游离κ轻链 游离λ轻链 游离κ轻链/游离λ轻链比值 参考区间 

分 类 号：R446.1[医药卫生—诊断学]