血清蛋白电泳、免疫球蛋白及其轻链测定对肝病患者的临床意义

目的探讨血清中免疫球蛋白和轻链测定以及血清蛋白电泳在肝病患者中的临床应用价值。方法用免疫散射比浊法在特定蛋白分析仪上检测92例肝病患者(包括急性肝炎患者28例、慢性肝炎患者33例、肝硬化患者31例)及45例健康者血清中免疫球蛋白IgG、IgA、IgM以及κ轻链和λ轻链的水平;用琼脂糖凝胶电泳法对所有样本进行血清蛋白电泳检测。结果与对照组相比,急性肝炎组以IgM升高为主,差异有统计学意义(P<0.05);两组κ轻链和λ轻链水平比较,差异无统计学意义(P>0.05)。急性肝炎组和肝硬化组IgG、IgA水平均高于对照组,差异有统计学意义(P<0.05);两组κ轻链和λ轻链水平分别与对照组比较,差异均有统计学意义(P<0.05)。血清蛋白电泳结果显示,急性肝炎组与对照组相比,两组γ区球蛋白含量比较,差异无统计学意义(P>0.05);慢性肝炎组和肝硬化组γ区球蛋白含量与对照组比较,差异有统计学意义(P<0.05)。结论血清中免疫球蛋白及其轻链的含量与肝脏疾病密切相关,慢性肝炎肝硬化患者血清蛋白电泳呈现典型的多克隆增殖图谱。血清蛋白电泳、免疫球蛋白和轻链水平的测定可作为肝脏功能监测的辅助指标。

Clinical significance of serum protein electrophoresis,immunoglobulin and light chain detection in liver disease

Objective To analyze the effect of serum protein electrophoresis（SPE）,immunoglobulin and light chain detection in the diagnosis of liver disease.Methods The serum levels of IgG,IgA,IgM,kappa light chain and lambda light chain in 92 patients with liver diseases（28 cases with acute hepatitis,33 cases with chronic hepatitis and 31 cases with liver cirrhosis） were detected by turbidimetry and then compared with the indexes in 45 healthy cases.SPE was detected by Helena Spife 3000 electrophoresis apparatus.Results Serum IgM level in patients with acute hepatitis was significantly higher than that in control group（P 〈0.05）.Kappa light chain and lambda light chain showed no significant difference between acute hepatitis group and control group.The serum levels of IgG,IgA,kappa light chain and lambda light chain in patients with chronic hepatitis and liver cirrhosis were significantly higher than that in control group（P 〈0.05）.SPE results showed that the level of γ globulin in patients with chronic hepatitis and liver cirrhosis were significantly higher than that in controls（P 〈0.05）.Conclusions The high level of immunoglobulin and light chain are related to liver disease.Serum protein electrophoresis,immunoglobulin and light chain detection have high value in laboratory monitoring of liver disease.