M蛋白与细胞免疫分型在高淋巴细胞比例老年人群中的表达  

Expression of M protein and cellular immunotyping in elderly population with high lymphohocytepercentage

作　　者：李作洁 付水 陈礼好 潘孝勇 陈阿德 胡明均 LI Zuo-jie;FU Shui;CHEN Li-hao;PAN Xiao-yong;CHEN A-de;HU Ming-jun(Clinical Laboratory,Cangnan County People's Hospital,Zhejiang 325800,China)

机构地区：[1]苍南县人民医院检验科,浙江325800 [2]杭州市临平区第一人民医院 [3]苍南县人民医院血液内科

出　　处：《中国卫生检验杂志》2023年第11期1346-1350,共5页Chinese Journal of Health Laboratory Technology

基　　金：温州市基础性医疗卫生科技项目(Y20210747)。

摘　　要：目的通过对外周血淋巴细胞比例>40%的老年人进行M蛋白筛查和细胞免疫分型的联合研究,分析不同外周血淋巴细胞比例M蛋白筛查和细胞免疫分型情况。方法按纳入和排除标准收集300例研究对象的血清和EDTA-K_(2)抗凝全血,按淋巴细胞比例分3组,同时选取100例外周血淋巴细胞比例≤40%健康体检者为对照组。对所有研究对象的血清用全自动血清蛋白电泳分析仪进行M蛋白筛查,并对所得结果进行统计分析。对所有研究对象的EDTA-K_(2)抗凝全血进行流式细胞免疫分型检测,所用单克隆抗体有CD3、CD5、CD19、CD22、CD38、CD45、CD56、CD138,并对所得结果进行统计分析。探查其中是否存在M蛋白阳性或细胞免疫分型异常表达。结果总实验组与对照组的M蛋白阳性率比较,差异有统计学意义(P<0.05);3组实验组分别与对照组的M蛋白阳性率比较,差异均有统计学意义(P<0.05)。总实验组与对照组的免疫分型异常表达率比较,差异有统计学意义(P<0.05);实验1组(40%~50%)与对照组的免疫分型异常表达率比较,差异无统计学意义(P>0.05);实验2组(>50%~60%)和实验3组(>60%)分别与对照组的免疫分型异常表达率比较,差异均有统计学意义(P<0.05)。结论外周血淋巴细胞比例≥50%且年龄≥60周岁的老年人M蛋白阳性率和细胞免疫分型异常表达率均较高,可能存在易漏诊和误诊的淋巴细胞增殖性疾病。建议临床方面对外周血淋巴细胞比例≥50%且年龄≥60周岁的老年人群进行血清蛋白电泳检测筛查M蛋白和细胞免疫分型检测。Objective A combined study of M protein screening and cellular immunotyping was carried out in elderly patients with peripheral blood lymphocyte proportion>40%,so as to analyze the M protein screening and cellular immunotyping of different proportions of peripheral blood lymphocytes.Methods Serum and EDTA-K_(2),anticoagulated whole blood of 300 subjects were collected according to the inclusion and exclusion criteria,and divided into three groups according to the proportion of lymphocytes.Another 100 healthy subjects with peripheral blood lymphocytes≤40%were selected as the control group.The serum of all subjects was conducted for the screening of M protein by automatic serum protein electrophoresis analyzer,and the results were statistically analyzed.CD3,CD5,CD19,CD22,CD38,CD45,CD56 and CD138 monoclonal antibodies were used to detect EDTA-K_(2),anticoagulated whole blood by flow cytometry,and the results were statistically analyzed,so as to explore whether there is M protein positive or abnormal expression of cellular immune typing.Results The positive rate of M protein was significantly dfferent between the total experimental group and the control group,with the differences statistically significant(P<0.05).The positive rates of M protein in the three groups were compared with those in the control group,and the differences were statistically significant(P<0.05).There was statistical significance on the difference in the abnormal expression rate of immunotyping between the total experimental group and the control group(P<0.05).There was no statistical significance on the difference in the abnormal expression rate of immunotyping between experimental group 1(40%-50%)and control group(P>0.05).Compared with the control group,the abnormal expression rates of immunotyping in experimental group 2(>50%-60%)and experimental group 3(>60%)were statistically significant(P<0.05).Conclusion The positive rate of M protein and the abnormal expression rate of cellular immune typing are relatively high in the elderly aged≥60

关 键 词：M蛋白 细胞免疫分型 淋巴细胞 慢性淋巴细胞增殖性疾病 多发性骨髓瘤 

分 类 号：R446.6[医药卫生—诊断学]