摘要
目的 胱抑素C(Cys-C)、α1-微球蛋白(α1-MG)及尿微量白蛋白(UMA)单独及联合检测对多发性骨髓瘤(MM)合并肾损伤的诊断价值.方法 依据肾损伤情况将113例MM患者分为损伤组(n=36)和未损伤组(n=77),比较两组患者及不同肾损伤类型MM合并肾损伤患者的Cys-C、α1-MG及UMA水平.绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估Cys-C、α,-MG及UMA单独及联合检测对MM合并肾损伤的诊断价值.结果 未损伤组患者Cys-C、α1-MG及UMA水平均明显低于损伤组,差异均有统计学意义(P＜0.01).肾衰竭型MM患者Cys-C、α1-MG及UMA水平均明显高于肾病综合征型患者,差异均有统计学意义(P＜0.01).Cys-C、α1-MG及UMA联合检测诊断MM合并肾损伤的AUC为0.804(95％CI:0.733～0.876),灵敏度为0.889,特异度为0.909,均高于三者单独检测.结论 MM合并肾损伤患者Cys-C、α1-MG及UMA水平较高,三者联合检测诊断MM合并肾损伤的价值较高.
Abstract
Objective To investigate the diagnostic value of cystatin C(Cys-C),α1-microglobulin(α1-MG),and uri-nary microalbumin(UMA)single and combined detection in multiple myeloma(MM)with renal injury.Method A total of 113 MM patients were selected and divided into injury group(n=36)and non-injury group(n=77)based on renal injury status.The levels of Cys-C,α1-MG,and UMA were compared between the two groups and different types of MM patients combined with renal injury.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the Cys-C,α1-MG,and UMA single and combined detection in diagnosing MM combined with renal injury were evaluated.Result The Cys-C,α1-MG,and UMA levels in the non-injury group were significantly lower than those in the injury group,and the differences were statistically significant(P＜0.01).The Cys-C,α1-MG,and UMA levels in MM patients with renal failure type were significantly higher than those in nephrotic syndrome type pa-tients,and the differences were statistically significant(P＜0.01).The AUC of Cys-C,α1-MG,and UMA combined detec-tion in diagnosing MM combined with renal injury was 0.804(95％CI:0.733-0.876),the sensitivity was 0.889,and the specificity was 0.909,all of which were higher than those of single detection.Conclusion The Cys-C,α1-MG,and UMA levels are high in MM patients combined with renal injury,and the combined detection of the three has higher value in di-agnosing MM combined with renal injury.
基金项目
河南省医学科技攻关计划省部共建项目(SBGJ2018062)
万方数据