CAJ | 학술논문

目的：探讨血清游离轻链κ/λ比值（sFLC）在慢性肾病（CKD）患者肾损伤中的诊断价值。方法根据血清免疫固定电泳（IFE）结果和免疫透射比浊法测定血清游离轻链κ/λ比值，将95例慢性肾病患者分为3组：κ轻链阳性组（A组）30例；λ轻链阳性组（B组）30例；慢性肾功能不全对照组（C组）34例。另选取30例健康体检者作为对照组（D组）。用免疫透射比浊法检测血清中胱抑素C（Cys C）、C反应蛋白（CRP）、游离轻链κ和λ浓度水平及尿液中β2微球蛋白（β2-MG）、微量清蛋白（MA）和24小时尿总蛋白（24 h PRO）水平；酶法检测血清肌酐（CREA）和尿液中N-乙酰-β-D葡萄糖苷酶（NAG）活性。结果 A 组、B组和C 组血清CREA、CRP、Cys C及尿液MA、β2-M、24 h PRO浓度水平和NAG活性均增高，与D组比较，差异有统计学意义（P＜0．01）。A组和B组血清CRP、Cys C及尿液 MA、β2-MG、24 h PRO浓度水平和NAG活性高于C组，差异有统计学意义（P＜0．01）。结论血清游离轻链κ/λ比值检测在CKD患者肾损伤程度评估中具有重要的临床意义。
목적：탐토혈청유리경련κ/λ비치（sFLC）재만성신병（CKD）환자신손상중적진단개치。방법근거혈청면역고정전영（IFE）결과화면역투사비탁법측정혈청유리경련κ/λ비치，장95례만성신병환자분위3조：κ경련양성조（A조）30례；λ경련양성조（B조）30례；만성신공능불전대조조（C조）34례。령선취30례건강체검자작위대조조（D조）。용면역투사비탁법검측혈청중광억소C（Cys C）、C반응단백（CRP）、유리경련κ화λ농도수평급뇨액중β2미구단백（β2-MG）、미량청단백（MA）화24소시뇨총단백（24 h PRO）수평；매법검측혈청기항（CREA）화뇨액중N-을선-β-D포도당감매（NAG）활성。결과 A 조、B조화C 조혈청CREA、CRP、Cys C급뇨액MA、β2-M、24 h PRO농도수평화NAG활성균증고，여D조비교，차이유통계학의의（P＜0．01）。A조화B조혈청CRP、Cys C급뇨액 MA、β2-MG、24 h PRO농도수평화NAG활성고우C조，차이유통계학의의（P＜0．01）。결론혈청유리경련κ/λ비치검측재CKD환자신손상정도평고중구유중요적림상의의。
Objective To evaluate the clinical value of serum free light chain kappa/lambda ratio (sFLC)in kidney damage of patients with chronic kidney disease (CKD).Methods According to the results of serum immune fixation electrophoresis (IFE) and serum free light chainκ/λratio,95 cases of patients with chronic kidney disease were divided into three groups:kappa light chain predominate positive group (group A)30 cases,lambda light chain positive group of 31 cases (group B),chronic renal insuffi-ciency in the control group (C group)34 cases and 30 cases of healthy physical examination were selected as control group (group D).Immunological transmission turbidimetry was used to detect serum cystatin C(Cys C),C-reactive protein(CRP),free blight chain kappa and lambda concentration levels.urine beta 2 microglobulin (β2-MG),trace albumin (MA)and 24 h urinary total pro-tein (24 h PRO)contents,serum creatinine (CREA)and urine N-acetyl-β-D glycosidase enzymes (NAG)activity were detected by enzymatic method.Results The serum CREA,CRP,Cys C and urine MA,β2-MG,24 h PRO concentration levels and NAG activity of group A,group B and group C were obviously higher than those of group D.Compared with group D,the difference was statisti-cally significant (P<0.01).The serum CRP,Cys C and urine MA,β2-MG,24 h PRO concentration levels and NAG activity of group A and group B were obviously higher than those of group C.The difference was statistically significant (P<0.01). Conclusion The measurement of serum free light chain kappa/lambda ratio in renal damage degree evaluation for patients with chronic kidney disease (CKD)has important clinical significance.