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[40岁以上人群意义未明的单克隆丙种球蛋白病发病率分析]

[Incidence Analysis of Monoclonal Gammopathy of Undetermined Significance in People over 40 Years of Age].

作者信息

Zhang Rui, Wang Liang, Zhang Zheng-Hao, Pang Nan-Nan, Zhao Jia-Lin, Qu Jian-Hua

机构信息

Center of Hematologic diseases, Medical Laboratory Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054,Xinjiang Uygur Autonomous Region, China.

Center of Hematologic diseases, Medical Laboratory Center, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054,Xinjiang Uygur Autonomous Region, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Apr;27(2):623-628. doi: 10.19746/j.cnki.issn.1009-2137.2019.02.051.

Abstract

OBJECTIVE

To study the distribution of monoclonal gammopathy of undetermined significance(MGUS) in different age, sex and ethnic people over 40 years old.

METHODS

Five hundred and ninety-six people(over 40 years old) examened in the Health Examination center of the First Affiliated Hospital of Xinjiang Medical University from July 2017 to September 2017 were selected. Among 596 people, male 310, female 286, Han people 488, and Uygur ethnic people 108. According to age, 596 people were divided into 3 groups, (40-59 years old group, 60-79 years old group, over 80 years old group). First, all samples were screened by capillary serum protein electrophoresis. If the suspected monoclonal bands were found in the electrophoretogram, and then the specific protein types were determined by serum immunofixation electrophoresis.

RESULTS

The total incidence of MGUS in 596 screened population was 4.027%. The incidence of MGUS in 40-59 years old group, 60-69 years old group and over 80 years old group were 1.762%, 2.929% and 10% respectively, and the differences among the groups were statistically significant(P<0.05). The incidence of MGUS in male (5.806%) was significantly higher than that in female (2.097%)(χ=5.177,P<0.05). Binary Logistic regression analysis showed that over 80 years old and male were independent risk factors for MGUS(P=0.001, OR=4.188, 95%CI: 1.814-9.673, P=0.048, OR=2.605, 95%CI: 1.009-6.725). The types of immunoglobulin in patients with MGUS were mostly IgG, IgG(66.7%) was significantly more than IgA (29.2%)(χ=21.375,P<0.05),and there was no significant difference in the incidence of MGUS between people with in Kappa and Lambda.

CONCLUSION

The age increase and male may increase the incidence of MGUS, the IgG is the most common type of immunoglobcdin in pathogenesis of MGUS, so the early screening should be done.

摘要

目的

研究意义未明的单克隆丙种球蛋白病(MGUS)在40岁以上不同年龄、性别及民族人群中的分布情况。

方法

选取2017年7月至2017年9月在新疆医科大学第一附属医院健康体检中心体检的596例40岁以上人群。其中男性310例,女性286例,汉族488例,维吾尔族108例。按年龄将596例人群分为3组(40~59岁组、60~79岁组、80岁以上组)。首先采用毛细管血清蛋白电泳对所有样本进行筛查,若电泳图谱中发现可疑单克隆条带,则进一步采用血清免疫固定电泳确定具体蛋白类型。

结果

596例受检人群中MGUS总发病率为4.027%。40~59岁组、60~69岁组及80岁以上组MGUS发病率分别为1.762%、2.929%和10%,组间差异有统计学意义(P<0.05)。男性MGUS发病率(5.806%)显著高于女性(2.097%)(χ=5.177,P<0.05)。二元Logistic回归分析显示,80岁以上及男性是MGUS的独立危险因素(P=0.001,OR=4.188,95%CI:1.814~9.673;P=0.048,OR=2.605,95%CI:1.009~6.725)。MGUS患者免疫球蛋白类型以IgG为主,IgG(66.7%)显著多于IgA(29.2%)(χ=21.375,P<0.05),κ型与λ型人群MGUS发病率差异无统计学意义。

结论

年龄增长及男性可能增加MGUS发病率,IgG是MGUS发病机制中最常见的免疫球蛋白类型,应进行早期筛查。

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