血清蛋白电泳识别M蛋白的规则制定及其在健康人群M蛋白筛查中的应用  

Rule making of M protein recognition by serum protein electrophoresis and its application in M protein screening among healthy subjects

作　　者：徐双[1] 路瑾[2] 赵磊[1] 裴林[1] 贾玫[1] 荣嵘[1] XU Shuang;LU Jin;ZHAO Lei;PEI Lin;JIA Mei;RONG Rong(Department of Clinical Laboratory,Peking University People's Hospital,Beijing 100044,China;Peking University Institute of Hematology,Beijing 100044,China)

机构地区：[1]北京大学人民医院检验科,北京100044 [2]北京大学血液病研究所,北京100044

出　　处：《检验医学》2020年第7期668-672,共5页Laboratory Medicine

基　　金：北京大学人民医院研究与发展基金资助项目(RED2019-09)。

摘　　要：目的建立血清蛋白电泳识别M蛋白的规则并进行验证。探讨该规则在健康人群中筛查M蛋白的价值。方法参照相关文献,依据M蛋白在血清蛋白电泳中出现的区域制定M蛋白的识别规则。对312例随机临床血清样本进行血清蛋白电泳,依据制定的M蛋白识别规则筛查M蛋白,并通过免疫固定电泳进行验证。收集1 170名健康体检者的血清样本及236例除血液科、肾内科、风湿免疫科、骨肿瘤科、肝病科和老年科外的患者血清样本,分别进行血清蛋白电泳,筛查M蛋白,采用免疫固定电泳对可疑样本进行确证并分型。结果 312例临床样本采用血清蛋白电泳筛选出28例可疑样本(含有M峰或可疑M峰),其中16例(5.12%)经免疫固定电泳确认为M蛋白阳性;血清蛋白电泳漏检1例,漏检率为0.32%。1 170例健康体检者中M蛋白阳性率为2.14%(25/1 170),男性阳性率(2.64%)高于女性(1.82%)。25例M蛋白阳性的健康体检者中,IgG型M蛋白阳性率最高(60%),其次为IgM型(24%)。236例除血液科、肾内科、风湿免疫科、骨肿瘤科、肝病科、老年科外的患者样本中有10例M蛋白血症,阳性率为4.24%。结论制定的M蛋白识别规则在血清蛋白电泳识别M蛋白中有较大的价值,值得推广应用。Objective To establish and verify the rule of M protein recognition by serum protein electrophoresis,and to investigate the role of this rule in screening M protein among healthy subjects. Methods According to related literatures,the rule of M protein recognition was established according to the region of M protein in serum protein electrophoresis. Serum protein electrophoresis was carried out in 312 random clinical serum samples. M protein was screened according to the established rule of M protein recognition,which was verified by immunofixation electrophoresis. Serum samples of 1 170 healthy subjects and 236 clinical samples excluding hematology,nephrology,rheumatology and immunology,bone tumor,hepatology and geriatrics were collected. Serum protein electrophoresis was performed on each sample. M protein was screened according to M protein recognition rule. Immunofixation electrophoresis was used to confirm and type suspicious samples. Results In the 312 random clinical serum samples,28 samples,including M peak or suspicious M peak,were screened by serum protein electrophoresis,among which 16(5.12%) samples were confirmed as M protein positive by immunofixation electrophoresis. One case was missed in serum protein electrophoresis,and the missed rate was 0.32%. The positive rate of M protein was 2.14%(25/1 170) in 1 170 healthy subjects. The positive rates of M protein were 2.64% in males and 1.82% in females. The positive rate of M protein in males was higher than that in females. Among the 25 M protein positive samples,the positive rate of IgG type M protein was the highest(60%),followed by IgM type(24%). Among the 236 clinical samples excluding hematology,nephrology,rheumatology and immunology,bone tumor,hepatology and geriatrics,10 cases had M protein,and the positive rate was 4.24%. Conclusions The established M protein recognition rule have a value in M protein recognition by serum protein electrophoresis,which is worth to be applied widely.

关 键 词：M蛋白 识别规则 血清蛋白电泳 意义未明的单克隆免疫球蛋白血症 

分 类 号：R446.1[医药卫生—诊断学]