β2MG及IL-6与非MM的MGP-KD疾病应用研究  

β2 A MGP-KD Disease Application Study in MG and IL-6 and Non-MM

作　　者：李丽 代建风 朱泉 候进 刘永芳 LI Li;DAI Jian-feng;ZHU Quan;HOU Jin;LIU Yong-fang(Jiujiang City Hospital of Traditional Chinese Medicine,Jiujiang 332000,Jiangxi Province,China)

机构地区：[1]九江市中医院急诊科,江西九江332000

出　　处：《罕少疾病杂志》2024年第10期125-127,共3页Journal of Rare and Uncommon Diseases

基　　金：江西省卫生健康委员科技计划(202211963)。

摘　　要：目的探讨血清白细胞介素-6(Interleukin-6,IL-6)联合血清β2-微球蛋白(β2-Microglobulin,β2-MG)在非多发性骨髓瘤(multiple myeloma,MM)的单克隆免疫球蛋白病相关肾病(monoclonal gammopathies-ssociated kidney disease,MGP-KD)诊断和MGP-KD发展中的应用价值。方法以2022年4月至2023年12月经九江市中医院就诊的92例MGP-KD患者为观察组,分为非MM的MGP-KD组(n=60例)和MM组(n=32例),同期选取60例健康体检者为对照组,统计三组基线资料,收集静脉血清样本,记录三组血清IL-6、β2-MG水平并进行比较,应用受试者工作曲线(receiver operating curve,ROC)评估IL-6、β2-MG单一及联合对非MM的MGP-KD的诊断效能和评估向MM发展的可能性,行血清样本肌酐(serum creatinine,Scr)测定计算肾小球滤过率(glomerular filtration rate,GFR)评价非MM的MGP-KD患者慢性肾脏病(chronic kidney disease,CKD)分期,并行骨髓穿刺观察骨髓形态学变化,按Greipp标准予以骨髓象划分,采用Spearson分析IL-6、β2-MG与CKD分期、骨髓象的相关性。结果经F分析,三组血清IL-6、β2-MG水平比较,差异有统计学意义(P<0.05),MM组、非MM的MGP-KD组血清IL-6、β2-MG水平均高于对照组,差异有统计学意义(P<0.05);MM组血清IL-6、β2-MG水平高于非MM的MGP-KD组,差异有统计学意义(P<0.05);经ROC曲线显示:IL-6、β2-MG单一评估非MM的MGP-KD发生及发展为MM均有一定诊断价值,均以血清IL-6联合β2-MG诊断价值最高,诊断MGP-KD发生AUC值为0.921,此时灵敏度、特异度依次为91.67%、85.00%;诊断MM发生AUC值为0.885,此时灵敏度、特异度依次为75.00%、90.00%;经Spearson相关性分析结果显示:IL-6、β2-MG与CKD分期均呈中度正相关(r值依次为0.504、0.532),IL-6、β2-MG与骨髓象均呈轻度负相关(r值依次为-0.433、-0.472)。结论非MM的MGP-KD患者IL-6、β2-MG水平呈异常高表达,两者联合预测非MM的MGP-KD发生及其发展诊断价值较高,且IL-6、β2-MG水平与CKD分期及骨髓象具Objective To investigate the value of serum interleukin-6(IL-6)combined with serumβ2-microglobulin(β2-MG)in the diagnosis and development of Monoclonal gammopathies-ssociated kidney disease(MGP-KD)in non-multiple myeloma(MM).Methods A total of 92 MGP-KD patients treated in our hospital from April 2022 to December 2023 were divided into the non-mm MGP-KD group(n=60 cases)and the MM group(n=32 cases).During the same period,60 healthy subjects were selected as the control group.Baseline data of the three groups were collected,and venous serum samples were collected.Serum levels of IL-6 andβ2-MG were recorded and compared among the three groups.Receiver operating curve(ROC)was used to evaluate the diagnostic efficacy of IL-6 andβ2-MG alone and in combination with non-MM MGP-KD and to evaluate the possibility of progression to MM.Serum creatinine(Scr)was measured and glomerular filtration rate(GFR)was calculated to evaluate the stage of chronic kidney disease(CKD)in non-mm MGP-KD patients.Bone marrow morphologic changes were observed by bone marrow aspiration,and bone marrow images were divided according to Greipp criteria.The correlation of IL-6 andβ2-MG with CKD stage and bone marrow image was analyzed by Spearson.Results By F analysis,the serum IL-6 andβ2-MG levels in three groups were significantly different(P<0.05),and the serum IL-6 andβ2-MG levels in MM group and non-mm MGP-KD group were higher than those in control group,the difference was statistically significant(P<0.05).The serum levels of IL-6 andβ2-MG in MM group were higher than those in MGP-KD group without MM,and the difference was statistically significant(P<0.05).The ROC curve showed that both IL-6 andβ2-MG had certain diagnostic value in evaluating the occurrence and progression of non-mm MGP-KD,and serum IL-6 combined withβ2-MG had the highest diagnostic value.The AUC value for diagnosing MGPKD was 0.921,and the sensitivity and specificity were 91.67%and 85.00%.The AUC value of diagnosed MM was 0.885,and the sensitivity and specificity we

关 键 词：单克隆免疫球蛋白病相关肾病 多发性骨髓瘤 白细胞介素-6 Β2微球蛋白 

分 类 号：R551.3[医药卫生—血液循环系统疾病]