Serum protein electrophoresis yog kev ntsuam xyuas los ntawm kev kuaj ntshav uas tso cai rau kev kuaj mob thiab saib xyuas ntau yam kab mob xws li monoclonal immunoglobulin, hypergammaglobulinemia thiab tsis tshua muaj hypogammaglobulinemia.

Serum protein electrophoresis (EPS) yog kev kuaj mob biology. Nws lub hom phiaj yog kev sib cais ntawm cov proteins uas muaj nyob rau hauv cov kua ib feem ntawm cov ntshav (cov ntshav). "Cov proteins no tseem ceeb ua lub luag haujlwm hauv kev thauj mus los ntau cov molecules (hormones, lipids, tshuaj, thiab lwm yam), thiab tseem koom nrog hauv coagulation, tiv thaiv kab mob thiab tswj ntshav siab. Qhov kev sib cais no yuav ua rau nws muaj peev xwm txheeb xyuas thiab txheeb xyuas lawv ", qhia txog Dr Sophie Lyon, kws kho mob biologist.

Kev tsom xam cov protein

Tom qab kuaj ntshav, cov proteins raug tshuaj xyuas los ntawm kev tsiv teb tsaws chaw hauv hluav taws xob. "Lawv mam li cais raws li lawv cov nqi hluav taws xob thiab lawv qhov hnyav molecular, uas ua rau nws muaj peev xwm txheeb xyuas lawv thiab pom qhov tsis txaus ntseeg." EPS yuav tso cai rau kev sib cais ntawm 60 feem pua ​​​​ntawm cov protein, hauv kev txo qis ntawm lawv txoj kev tsiv teb tsaws chaw: albumin (uas yog cov protein ntau hauv cov ntshav, ntawm qhov muaj txog 1%), alpha 2-globulins, alpha 1-globulins, Beta 2 globulin, Beta XNUMX globulin thiab gammaglobulins. "Electrophoresis ua rau nws muaj peev xwm txheeb xyuas qee yam pathologies txuas rau kev ua haujlwm tsis zoo ntawm lub siab lossis lub raum, rau kev hloov pauv ntawm lub cev tiv thaiv kab mob, rau cov tsos mob inflammatory lossis qee yam qog noj ntshav".

Cov xwm txheej ntawm kev sau tshuaj EPS tau teev tseg los ntawm Haute Autorité de Santé (HAS) thaum Lub Ib Hlis 2017. Qhov laj thawj tseem ceeb vim li cas EPS tau ua tiav yog kev tshawb fawb txog monoclonal immunoglobulin (monoclonal gammopathy, lossis dysglobulinemia). Qhov no yuav tsiv teb tsaws feem ntau hauv thaj tsam ntawm gamma globulins thiab qee zaum hauv thaj tsam ntawm beta-globulins lossis txawm tias alpha2-globulins.

Thaum twg thiaj ua tau PSE?

Koj yuav tsum ua EPS thaum koj nyob pem hauv ntej:

• Ib qib siab ntawm cov protein ntau;
• Unexplained nce sedimentation tus nqi (VS);
• Cov kab mob rov ua dua, tshwj xeeb yog kab mob (nrhiav kev tiv thaiv kab mob tsis muaj peev xwm ua rau hypogammaglobulinemia);
• Clinical lossis biological manifestations (hypercalcemia, piv txwv li) qhia txog qhov tshwm sim ntawm myeloma lossis kab mob ntshav;
• Ib qho kev xav ntawm inflammatory syndrome;
• Tejzaum yog cirrhosis;
• Ib qho kev tshawb nrhiav ntawm osteoporosis.

Nyob ntawm cov protein, cov txiaj ntsig siv yuav tsum nyob nruab nrab ntawm:

• Albumin: 55 thiab 65% lossis 36 thiab 50 g / L.
• Alpha1 - globulins: 1 thiab 4% piv txwv li 1 thiab 5 g / L
• .Alpha 2 – globulins: 6 thiab 10% los yog 4 thiab 8 g / l
• .Beta – globulins: 8 thiab 14% lossis 5 thiab 12 g / L.
• Gamma - globulins: 12 thiab 20% lossis 8 thiab 16 g / L.
  

Electrophoresis tom qab ntawd yuav txheeb xyuas pawg ntawm cov protein ntau ntxiv lossis txo qis hauv cov ntshav. "Txhua cov ntshav protein yuav tsim cov kab sib txawv ntawm qhov dav thiab siv zog nyob ntawm lawv qhov ntau. Txhua tus yam ntxwv "profile" tuaj yeem txhais los ntawm tus kws kho mob ". Nws muaj peev xwm, yog tias tsim nyog, sau ntawv tshuaj ntsuam xyuas ntxiv.

Cov kev tsis sib haum xeeb tau txheeb xyuas los ntawm EPS

Ntawm cov anomalies pom:

• Kev txo qis ntawm qib albumin (hypoalbuminemia), uas tuaj yeem tshwm sim los ntawm kev noj zaub mov tsis txaus, daim siab tsis ua haujlwm, kab mob ntev, myeloma lossis txawm tias dej ntau dhau (hemodilution).
• Hyper-alpha2-globulinemia thiab txo qis hauv albumin yog ib qho kev sib txuas nrog lub xeev inflammatory. Ib qho kev sib xyaw ntawm beta thiab gamma fractions qhia tias cirrhosis.
• Kev txo qis hauv gamma globulins (hypogammaglobulinemia) raug pom thaum muaj kev ua haujlwm tsis zoo ntawm lub cev. Ntawm qhov tod tes, tus nqi nce (hypergammaglobulinemia) nyob rau hauv qhov xwm txheej ntawm myeloma, monoclonal gammopathies thiab kab mob autoimmune (lupus, rheumatoid mob caj dab).
• Kev nce hauv beta globulins tuaj yeem txhais tau tias muaj cov hlau tsis muaj peev xwm, hypothyroidism lossis biliary obstruction.

Raws li HAS, nws raug nquahu kom xa tus neeg mob rau cov lus qhia ntxiv:

• Yog hais tias tus neeg mob qhov kev soj ntsuam kev nthuav qhia qhia hematologic malignancy (mob pob txha, deterioration ntawm tus mob, lymphadenopathy, qog syndrome);
• nyob rau hauv cov xwm txheej ntawm ib tug kab mob abnormality (anemia, hypercalcemia, lub raum tsis ua hauj lwm) los yog imaging (pob txha lesions) qhia txog kev puas tsuaj rau lub cev;
• Yog tias tsis muaj cov tsos mob zoo li no, tus neeg mob uas tsawg kawg ib qho ntawm cov kev kuaj thawj kab yog qhov txawv txav, lossis nws cov serum monoclonal immunoglobulin yog IgG? 15 g / L, IgA lossis IgM? 10 g / L;
• yog tias tus neeg mob muaj hnub nyoog qis dua 60 xyoo.

Kev kho mob ntawm ib qho anomaly ntawm electrophoresis yog qhov ntawm pathology uas nws nthuav tawm.

"Piv txwv li, nyob rau hauv cov ntaub ntawv ntawm tag nrho cov hyperprotidemia vim lub cev qhuav dej, kev kho mob yuav rov ua dej dua. Yog tias muaj qhov nce hauv alpha globulins vim yog qhov mob inflammatory, kev kho mob yuav yog qhov ua rau mob. Nyob rau hauv txhua rooj plaub, nws yog tus kws kho mob uas, siv qhov kev ntsuam xyuas no nrog rau lwm yam kev kuaj ntxiv (kev kuaj ntshav, kuaj hluav taws xob, thiab lwm yam), yuav ua rau kev kuaj mob thaum lub sij hawm sib tham thiab yuav sau cov kev kho mob kom haum rau cov kab mob pathology. pom ”.