初诊单克隆丙种球蛋白合并贫血患者的临床及实验室特征分析  

Clinical and Laboratory Characteristic Analysis of Patients with Newly Diagnosed Monoclonal Gammopathy Combined with Anemia

作　　者：钱晗 伍月霞 杨敏[1] 虎玉婷 孔玉洁 刘倩 许颖[1] QIAN Han;WU Yue-Xia;YANG Min;HU Yu-Ting;KONG Yu-Jie;LIU Qian;XU Ying(Department of Clinical Laboratory Examination,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Department of Clinical Laboratory Examination,Shuangliu District Second People’s Hospital,Chengdu 610200,Sichuan Province,China)

机构地区：[1]成都医学院第一附属医院检验科,四川成都610500 [2]双流区第二人民医院检验科,四川成都610200

出　　处：《中国实验血液学杂志》2025年第2期587-592,共6页Journal of Experimental Hematology

基　　金：成都市医学科研课题项目(2023171)。

摘　　要：目的:研究单克隆丙种球蛋白(MG)合并贫血患者的临床及实验室特征,探究单克隆丙种球蛋白合并贫血的危险因素。方法:回顾性分析2016年1月至2024年2月在成都医学院第一附属医院就诊并进行免疫固定电泳的5539例患者,最终筛选出初诊M蛋白阳性患者351例作为研究对象,其中贫血组270例、非贫血组81例,比较两组患者的实验室检验结果,Logistic回归模型分析贫血的危险因素。ROC曲线评价危险因素在单克隆免疫球蛋白合并贫血中的预测价值。结果:非贫血患者占比23.1%(81/351),中位年龄67(60-75)岁;贫血患者占比76.9%(270/351),中位年龄70(63-75)岁。贫血组的TP、GLB、UREA、CREA、UA、β_(2)-MG、CER水平均明显高于非贫血组(P<0.05),而ALB、ANC、ALC、AMC、补体C3、补体C4、HP、TRF水平均明显低于非贫血组(P<0.05)。校正后多因素Logistic回归分析,结果显示,GLB升高、β_(2)-MG升高、ANC降低、补体C3水平降低是单克隆丙种球蛋白发生贫血的独立危险因素(P<0.05)。ROC曲线分析结果显示,GLB、β_(2)-MG、ANC、补体C3水平对单克隆丙种球蛋白发生贫血具有较好的预测价值。结论:GLB升高、β_(2)-MG升高、ANC降低、补体C3降低是单克隆丙种球蛋白患者发生贫血的独立危险因素(P<0.05),四者联合评价对单克隆丙种球蛋白发生贫血具有较好的预测价值。Objective:To study the clinical and laboratory characteristics of monoclonal gammopathy anemia and explore the risk factors associated with anemia in monoclonal gammopathy.Methods:A retrospective analysis was conducted on 5539 patients who underwent immunofixation electrophoresis at the First Affiliated Hospital of Chengdu Medical College from January 2016 to February 2024.A total of 351 newly diagnosed M protein positive patients were selected as the study subjects,including 270 in the anemia group and 81 in the non-anemia group.Laboratory test results were compared between the two groups,and logistic regression models were used to analyze the risk factors for anemia.ROC curve analysis was performed to evaluate the predictive value of risk factors for anemia in monoclonal gammopathy.Results:The proportion of non-anemic patients was 23.1%(81/351),with a median age of 67(60-75)years;the proportion of anemic patients was 76.9%(270/351),with a median age of 70(63-75)years.The total protein,globulin,urea,creatinine,uric acid,β_(2)-microglobulin,and ceruloplasmin levels in the anemia group were higher than those in the non-anemia group(P<0.05),while albumin,neutrophil count,lymphocyte count,monocyte count,complement C3,complement C4,haptoglobin,and transferrin levels were lower in the non-anemia group(P<0.05).After adjustment,multivariate logistic regression analysis shows that elevated GLB,increasedβ_(2)-MG,decreased ANC,and reduced complement C3 were independent risk factors for anemia in monoclonal gammopathy(P<0.05).ROC curve analysis demonstrates that GLB,β_(2)-MG,ANC,and complement C3 had good predictive value for anemia associated with monoclonal gammopathy.Conclusion:Elevated GLB,increasedβ_(2)-MG,decreased ANC,and reduced complement C3 are independent risk factors for anemia in monoclonal gammopathy(P<0.05).The combined assessment of these four factors has good predictive value for anemia in monoclonal gammopathy.

关 键 词：单克隆丙种球蛋白 贫血 特征性分析 危险因素 

分 类 号：R556.5[医药卫生—血液循环系统疾病]