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采用两种检测方法观察肾功能不全患者血清和尿液中游离轻链的变化及意义。

Using Two Detection Methods to Observe the Changes and Significance of Free Light Chain in Serum and Urine in Patients with Renal Insufficiency.

机构信息

Department of Nephrology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, China 100730.

出版信息

Biomed Res Int. 2022 Mar 29;2022:5536199. doi: 10.1155/2022/5536199. eCollection 2022.

DOI:10.1155/2022/5536199
PMID:35392256
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8983191/
Abstract

BACKGROUND

Free light chains and (FLC , FLC ) are of great significance in diagnostic and monitoring monoclonal gammopathy. Freelite and N-Latex methods are two common monitoring methods at present. But the two meanings are not completely equivalent, especially for patients with renal insufficiency. We analyzed the changes of serum and urine FLC in renal insufficiency patients without monoclonal gammopathy and the clinical significance of these changes.

METHODS

This study is an observational study. Patients ≥ 18 years old, who met the diagnostic criteria of chronic kidney disease (CKD), excluding monoclonal gammopathy, were selected. Fasting serum and 24-hour urine were taken to detect serum FLC , serum FLC , SCr, serum -microglobulin, urinary FLC , urinary FLC , urinary -microglobulin, and urinary -microglobulin.

RESULTS

There was a good correlation between the two methods for determining serum/urinary FLC. No matter serum or urine, FLC showed a good correlation with renal function by the N-Latex method, but not by the Freelite method. Under the N-Latex method, FLC / remained stable, which was basically within the reference range of healthy people and was not affected by renal function. There was a good correlation between FLC detected by N-Latex and microglobulin in serum and urine.

CONCLUSION

When the concentration of FLC is low, the N-Latex method is more recommended to monitor FLC. The FLC measured by the N-Latex method is more closely related to renal function. The ratio of FLC / determined by the N-Latex method remained stable within the recommended range.

摘要

背景

游离轻链(FLC)在单克隆丙种球蛋白病的诊断和监测中具有重要意义。Freelite 和 N-Latex 法是目前常用的两种监测方法,但两种方法的意义并不完全等同,尤其是对于肾功能不全的患者。我们分析了无单克隆丙种球蛋白病的肾功能不全患者血清和尿液 FLC 的变化及其临床意义。

方法

这是一项观察性研究。选择年龄≥18 岁,符合慢性肾脏病(CKD)诊断标准,排除单克隆丙种球蛋白病的患者。采集空腹血清和 24 小时尿液,检测血清 FLC、血清 FLC、SCr、血清β2-微球蛋白、尿液 FLC、尿液 FLC、尿液β2-微球蛋白。

结果

两种方法测定血清/尿液 FLC 相关性良好。无论是血清还是尿液,N-Latex 法均与肾功能有较好的相关性,而 Freelite 法则无相关性。在 N-Latex 法中,FLC/保持稳定,基本处于健康人群的参考范围,不受肾功能影响。N-Latex 法检测的 FLC 与血清和尿液中的微球蛋白有良好的相关性。

结论

当 FLC 浓度较低时,建议使用 N-Latex 法监测 FLC。N-Latex 法测定的 FLC 与肾功能的相关性更强。N-Latex 法测定的 FLC/比值在推荐范围内保持稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a92/8983191/7bad645c82c5/BMRI2022-5536199.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a92/8983191/9bb63357407c/BMRI2022-5536199.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a92/8983191/7bad645c82c5/BMRI2022-5536199.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a92/8983191/9bb63357407c/BMRI2022-5536199.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a92/8983191/7bad645c82c5/BMRI2022-5536199.002.jpg

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本文引用的文献

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Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients.慢性肾脏病患者中两种无血清轻链检测方法的比较
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Different immunoreactivity of monomers and dimers makes automated free light chains assays not equivalent.单体和二聚体的不同免疫反应使得自动化游离轻链检测不可等效。
Clin Chem Lab Med. 2018 Dec 19;57(2):221-229. doi: 10.1515/cclm-2018-0412.
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Evaluation of the Impact of Renal Failure on Correlation and Concordance Between 2 Free Light Chain Assays.评估肾衰竭对两种游离轻链检测方法之间相关性和一致性的影响。
Clin Lymphoma Myeloma Leuk. 2016 Dec;16(12):693-704. doi: 10.1016/j.clml.2016.08.012. Epub 2016 Aug 10.
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