原发性干燥综合征患者血清免疫球蛋白轻链的测定及其临床意义

目的探讨血清游离免疫球蛋白轻链含量测定对在原发性干燥综合征患者的临床意义。方法收集该院2007年1月至2009年11月门诊及住院收治的原发性干燥综合征患者74例和2009年12月份健康体检者80例,采用散射免疫比浊法测定免疫球蛋白中κ和λ轻链水平。结果 74例原发性干燥综合征患者和80例健康对照者血清κ轻链水平分别为（19.60±8.50）g/L、（15.18±3.47）g/L;λ分别为（8.88±3.31）g/L、（5.70±1.66）g/L。κ、λ链在原发性干燥综合征患者血清中均显著高于健康对照组,差异有统计学意义（P〈0.05）。其中干燥综合征患者组中有系统损害者29例（占39.2%）,κ、λ轻链水平在有系统损害者比无系统损害者明显增高,差异有统计学意义（P〈0.05）;且κ、λ链与IgG、IgA水平之间均存在直线相关关系（均P〈0.05）,而与类风湿因子（RF）、IgM、年龄及病程无相关性（P〉0.05）。结论原发性干燥综合征患者血清中免疫球蛋白轻链水平的增高提示有系统损害,它可望成为一种免疫学参考指标。

Clinical Significance of Serum Light Chain in Patients with Primary Sj(o)igren Syndrome

Objective To test the levels and evaluate clinical significance of serum light chain in patients with Sjgren syndrome （ pSS） . Methods Blood samples were collected from 74 pSS patients and 80 healthy people. Serum κ and λ light chain levels were tested by rate nephelometer measures. Results The mean levels of κ chains in patients and healthy people were （ 19. 60 ± 8. 50） g/L,（ 15. 18 ± 3. 47） g/ L; the mean levels of λ light chains were （ 8. 88 ± 3. 31） g/L,（ 5. 70 ± 1. 66） g/L. The differences of κ and λ light chains levels between patients and healthy people were significant different （ P 0. 05） . 39. 2% pSS patients had extraglandular involvement,contrast to those who had no extraglandular involvement patients,the mean levels of serum κ and λ light chain were significantly higher respectively （ P 0. 05） . Moreover,κ and λ light chain levels were correlated with IgG and IgA （ P 0. 05） ; but had no correlations with RF、IgM、age and disease duration （ P 0. 05） . Conclusion The levels of κ and λ light chains in sera of pSS patients are higher than those in healthy people,especially in patients with extraglandular involvement. The higher κ and λ light chain levels are correlated with IgG and IgA levels. Detecting the levels of k and λ light chains in serum of patients is a helpful immunological method to detect Sjgrens syndrome,and its levels indicated whether there are extraglandular involvement.