IgM型单克隆免疫球蛋白阳性107例临床特征分析

发布时间：2018-04-26 06:25

本文选题：单克隆IgM + 原发性巨球蛋白血症　；参考：《中国实用内科杂志》2016年02期

【摘要】：目的提高对IgM型单克隆免疫球蛋白阳性的鉴别诊断,减少漏诊与误诊。方法收集2007年9月至2014年9月北京大学人民医院IgM型单克隆免疫球蛋白阳性患者107例,分析病种分布及临床特征,并检测频率最高的5种疾病的免疫球蛋白、β_2微球蛋白(β_2MG)水平及华氏巨球蛋白血症(WM)患者免疫表型。结果 107例患者中,主要为WM(51.4%,55例),其次边缘带淋巴瘤(15.9%,17例),意义未明的单克隆球蛋白增多症(10.3%,共11例),1例免疫缺陷病。不同疾病组间IgM水平、IgA水平及β_2MG水平差异有统计学意义(均P0.05)。IgM水平WM组最高,为32.9(18.3,59.3)g/L。55例WM患者免疫表型sIg阳性100%、CD20阳性100%,CD19阳性95.9%,CD5阳性7.4%、CD10阳性11.5%、CD23阳性32%。结论免疫球蛋白含量以及β_2MG水平可为WM与其他伴IgM型单克隆免疫球蛋白B细胞疾病鉴别诊断提供帮助,免疫分型是诊断该类疾病的主要手段。
[Abstract]:Objective to improve the differential diagnosis of IgM monoclonal immunoglobulin positive and to reduce missed diagnosis and misdiagnosis. Methods from September 2007 to September 2014, 107 patients with IgM type monoclonal immunoglobulin positive in Peking University people's Hospital were collected and their distribution and clinical characteristics were analyzed. The immunoglobulins of the five diseases with the highest frequency, the level of 尾 2 microglobulin (尾 2 MG) and the immunophenotype of patients with Fahrenheit macroglobulinemia (WM) were detected. Results among the 107 patients, 55 cases were mainly WMN 51.4, and 17 cases were marginal zone lymphoma (Lymphoma 15. 9). Monoclonal globulin hyperplasia (MGG) with unknown significance was 10. 3%, and 11 cases had 1 immunodeficiency disease. There were significant differences in IgM level and 尾 2MG level between different disease groups (all P0.05).IgM levels were the highest in WM group, which were 32.9% 18.3 / 59.3 g / L). The immunophenotypic sIg was 100% positive and CD20 positive 100% CD19 positive 95.9% CD5 positive 7.4T CD10 positive 7.4T + 7.4T + 7.4g / L. 55 cases of WM patients were found to be positive for CD10 and 11.5g / L. 55 cases of WM were found to be positive for CD23, CD23 and CD23, respectively. Conclusion the content of immunoglobulin and the level of 尾 _ 2MG can be helpful for the differential diagnosis between WM and other IgM type monoclonal immunoglobulin B cell diseases, and immunophenotyping is the main method for the diagnosis of these diseases.
【作者单位】：北京大学人民医院检验科;北京大学血液病研究所;
【基金】：科技部重大专项创新药物研究开发技术平台建设(2012ZX0903019)
【分类号】：R446.6

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