IgD型与其他类型多发性骨髓瘤实验室检查结果比较分析

目的：探讨临床上较为少见的IgD型多发性骨髓瘤（MM）的实验室特点，分析其与常见型MM患者实验室检查结果的异同。方法选择2009年11月至2013年11月在该院住院治疗的152例MM患者进行骨髓穿刺检查和免疫固定电泳（IFE）、免疫球蛋白（Ig）定量和血脂测定，比较分析IgD型与其他各型MM检测结果的差异。结果 IgD型MM患者原始浆细胞和幼稚浆细胞百分比显著高于IgG型和IgA型，差异有统计学意义（P＜0.05）；IgD型MM患者以λ轻链升高为主（87.5%，7/8），且轻链比值异常；各型之间血清异常免疫球蛋白检出率比较，差异无统计学意义（P＞0.05）；IgD型患者三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平与轻链型患者比较，差异无统计学意义（P＞0.05）；与IgG 型和IgA 型患者比较，IgD 型患者各项指标显著升高，差异有统计学意义（P＜0.05）；MM患者血清TC、LDL-C和HDL-C较对照组显著降低，差异有统计学意义（P＜0.05）。结论实验室诊断能够区分IgD型与其他类型MM，避免IgD型MM的漏诊和误诊。

Comparative analysis of the laboratory results of IgD and other types multiple myeloma

Objective To explore the laboratory characteristics of IgD type multiple myeloma （MM）,which is rare in clin-ic,and analyze the similarities and differences between inspection results of common types of MM. Methods A total of 152 MM patients,who were hospitalized in the hospital from November 2009 to November 2013,were chosen to observe bone marrow aspi-ration,immunofixation electrophoresis（IFE）,immunoglobulin（Ig） quantitatively and blood lipid,and to compare the results of IgD MM and the other types. Results The percentage of primitive cells and juvenile cells of IgD MM was obviously higher than those of IgG MM and IgA MM with statistically significant difference（P〈0.05）;the quantitative of light chain of IgD MM was mainλlight chain（87.5%,7/8）,and the ratio of light chain was anomaly;there was no statistically significant difference on the detection rate of serum abnormal immune globulin among all the MM types（P〉0.05）;there were no statistically significant differences on the levels of triglyceride （TG）,total cholesterol （TC）,low density lipoprotein cholesterin （LDL-C） and high density lipoprotein cholesterin（HDL-C） between IgD MM and light chain type MM（P〉0.05）;compared with the IgG MM and IgA MM,all indicators of IgD patients increased obviously with statistically significant difference（P〈0.05）;the levels of TC,LDL-C and HDL-C of MM pa-tients were significant lower than those of the healthy people with statistically significant difference（P〈0.05）. Conclusion The laboratory diagnosis of MM patients can distinguish the IgD type from other types of MM,and avoid missed diagnosis and misdiagnosis.