5029例血清免疫固定电泳检测结果分析  

An Analysis of 5 029 Samples of Serum Immunofixation Electrophoresis in a Hospital

作　　者：刘紫薇 王玉飞 谷愉愉 姜文灿 王利娟[1] 刘淑静[1] 陈柯霖[1] LIU Ziwei;WANG Yufei;GU Yuyu;JIANG Wencan;WANG Lijuan;LIU Shujing;CHEN Kelin(Department of Clinical Laboratory,Beijing Tiantan Hospital,Capital Medical University,NMPA Key Laboratory for Quality Control of In Vitro Diagnostics,Beijing Engineering Research Center of Immunological Reagents Clinical Research,Beijing,100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心,国家药监局体外诊断试剂质量控制重点实验室,北京市免疫试剂临床工程技术研究中心,北京100070

出　　处：《标记免疫分析与临床》2024年第12期2336-2341,共6页Labeled Immunoassays and Clinical Medicine

基　　金：北京市科学技术协会青年人才托举工程(编号:BYESS2022170)。

摘　　要：目的 回顾性分析5 029例血清免疫固定电泳检测结果,探讨单克隆免疫球蛋白在临床就诊患者的分布特点和诊断规律。方法 选取2019年1月至2023年12月在首都医科大学附属北京天坛医院就诊的5 029例患者,使用琼脂糖凝胶电泳进行单克隆免疫球蛋白的检测。结果 在5 029例进行血清免疫固定电泳检测的患者中,阳性检出率为5.31%(267/5 029),其中IgG型最多,占比44.57%(119/267);IgA型次之,占比25.09%(67/267);IgM型较少,占比13.48%(36/267),此外,还检测出轻链型37例和双克隆8例,分别占比13.86%和3.00%。不同性别和各年龄段间阳性检出率差异具有统计学意义,男性患者占比高于女性,且>70岁年龄组阳性检出率最高。根据送检科室情况分析,神经肌肉科送检例数高达2 138例,阳性率最高的科室是血液内科,为32.99%,不同送检科室的阳性检出率差异具有统计学意义。在不同疾病或症状中,血清免疫固定电泳的阳性率具有统计学意义,阳性率最高为多发性骨髓瘤,其次为单克隆丙种球蛋白血症、淋巴瘤、贫血、颅内占位性病变等。同时分析单克隆免疫球蛋白阳性的12例周围神经病患者,男性患者高于女性,检测结果以IgG和IgA型为主。结论 单克隆免疫蛋白的检出所对应疾病及临床症状各有不同,利用血清免疫固定电泳技术除能检出此蛋白外,还能对其进行分型,为早期临床诊断和治疗提供了重要依据。Objective To investigate the distributional characteristics and diagnostic criteria of monoclonal immunoglobulins in clinical patients.Methods A total of 5 029 patients who were treated at Beijing Tiantan Hospital,an affiliate of Capital Medical University,between January,2019 to December,2023,were selected for the detection of monoclonal immunoglobulin by agarose gel electrophoresis.Results The positive rate of serum immunofixation electrophoresis was 5.31%(267/5 029),among which IgG type was the highest,accounting for 44.57%(119/267),followed by IgA type,accounting for 25.09%(67/267).IgM type was relatively less identified,accounting for 13.48%(36/267).In addition,37 cases of light chain type and 8 cases of double clone were detected,accounting for 13.86% and 3.00% respectively.The discrepancy in the positive detection rates between diverse genders and age brackets was statistically significant,indicating a higher prevalence rate among male patients compared to female patients.Additionally,the highest detection rate was found in the demographic of individuals aged over 70 years.According to the analysis of the examination departments,the number of examination cases in the Department of Neuromuscular was up to 2 138,and the maximum positive percentage recorded was 32.99% within the Hematology Division.Statistically significant differences in the positive rates of serum immunofixation electrophoresis were observed among various diseases and symptoms.The condition with the highest positive rate was multiple myeloma,succeeded by monoclonal gammaglobulinemia,lymphoma,anemia,and intracranial space-occupying lesions.Concurrently,a cohort of 12 patients diagnosed with peripheral neuropathy,who tested positive for monoclonal immunoglobulins,was subjected to comprehensive analysis.Notably,the prevalence among male patients surpassed that of their female counterparts.The predominant immunoglobulin types detected were IgG and IgA.Conclusion The detection of monoclonal immunoglobulins is indicative of various diseases and c

关 键 词：免疫固定电泳 多发性骨髓瘤 单克隆免疫球蛋白 

分 类 号：R392-33[医药卫生—免疫学]