生化指标联合检测对多发性骨髓瘤早期肾损伤的诊断价值

摘要

Objective To discuss the diagnostic value of serum cystatin-C(Cys-C) and urinary retinol binding protein(RBP) for the early renal impairment in multiple myeloma(MM) patients .Methods According to estimated glomerular filtration rate(eGFR) , the MM patients were divided into two groups :the normal renal function group(eGFR≥90 mL/min ,n=78)marked group A ,the renal impairment group(eGFR<90 mL/min ,n=40)marked group B .130 healthy subjects were selected as control group .The con-centrations of serum Cys-C ,urinary RBP ,serum creatinine(Cr) and serum urea nitrogen(UN) were measured and compared .Results The levels of Cys-C and RBP in group A were significantly higher than those in the control group(P<0 .01) .There were signifi-cant difference of the levels of Cys-C ,Cr ,UN and RBP levels between group B and control group(P<0 .01) .The sensitivity of the combined detection of Cys-C and RBP was 57 .69% ,significantly higher than single index test(P<0 .05) .Conclusion Compared with traditional biomarkers ,Cys-C and RBP are more sensitive and effective indexes for the diagnosis of early renal impairment in the patients with MM ,and jointed detection of the two biomarkers has important value .%目的：探讨血清胱抑素C（Cys-C）、尿视黄醇结合蛋白（RBP）对多发性骨髓瘤（MM）患者早期肾损伤的诊断价值。方法根据肾小球滤过率估计值（eGFR）将MM患者分为两组：A组为肾功能正常组（eGFR≥90 mL/min）78例；B组为肾功能损伤组（eGFR＜90 mL/min）40例。130例健康体检者作为对照组。检测并比较各组血清Cys-C、尿RBP、血清尿素氮（UN）、血清肌酐（Cr）水平。结果 A组MM患者Cys-C和RBP水平与对照组比较，差异有统计学意义（P＜0．01），B组Cys-C、Cr、UN、尿RBP水平均显著高于对照组（P＜0．01）。Cys-C和尿RBP联合检测的阳性率为57．69％，明显高于单项检测（P＜0．05）。结论 Cys-C和RB P比传统指标能更有效地诊断M M患者早期肾损伤，联合检测具有重要价值。