血清果糖胺/白蛋白比值对IgA型多发性骨髓瘤的诊断价值

Value of serum fructosamine/albumin ratio in diagnosis of IgA type multiple myeloma

关键词:  果糖胺；果糖胺/白蛋白比值；免疫球蛋白A  多发性骨髓瘤；受试者工作特征曲线

Key words:  fructosamine  fructosamine/albumin ratio  immunoglobulin A  multiple myeloma  receiver operating characteristic (ROC) curve

摘要:

目的　探讨血清果糖胺/白蛋白（fructosamine/albumin,FMN/ALB）比值对IgA型多发性骨髓瘤（multiple myeloma,MM）的诊断价值。方法　选取IgA型MM患者（IgA型组）67例，自身免疫病（autoimmune disease，AID）患者60例（AID组）以及健康体检者50例（对照组），检测各组血清FMN、ALB、空腹血糖、糖化血红蛋白、IgA水平，并计算FMN/ALB比值，比较3组间各指标的差异。应用受试者工作特征曲线（ROC）评价各指标对IgA型MM的诊断效能。所有入选病例均排除糖尿病。结果　 IgA型组IgA、FMN、FMN/ALB水平明显高于AID组和对照组，差异有统计学意义（P<0.05）；诊断IgA型MM曲线下面积（AUC）IgA最大为0.981，FMN/ALB为0.970，FMN为0.963；诊断的敏感度FMN/ALB最高为91.0%，FMN为88.1%，IgA为82.1%；诊断的特异度IgA最高为100%，FMN/ALB为98.0%，FMN为97.0%。结论　血清FMN、FMN/ALB对IgA型MM诊断有较高的准确性，FMN/ALB比值可提高IgA型MM的诊断效能。

Abstract:

Objective To explore value of serum fructosamine/albumin(FMN/ALB) ratio in diagnosis of IgA type multiple myeloma(MM).Methods Sixty seven patients with IgA type MM (IgA type group),60 patients with autoimmune disease (AID group) and 50 people with healthy examination (control group) were selected. All selected cases were excluded with diabetes. The levels of FMN, ALB, fasting plasma glucose, hemoglobin A1c and IgA were detected respectively. The results were analyzed with receiver operating characteristic (ROC) curve for the diagnosis of IgA type MM. Results The levels of IgA, FMN,FMN/ALB in IgA type group were significantly higher than those in AID group and control group（P<0.05）.The AUC of IgA (0.981) was the largest, followed by FMN/ALB ratio (0.970) and FMN (0.963). The most sensitive index was FMN/ALB ratio (91.0%), FMN (88.1%), and IgA (82.1%). The most specificity index was IgA (100%), FMN/ALB ratio (98.0%) and FMN (97.0%). Conclusion Serum FMN and FMN/ALB ratio have higher accuracy in diagnosis of IgA type multiple myeloma. FMN/ALB ratio would improve the diagnostic efficiency.