目的　评价血清免疫球蛋白定量、血清蛋白电泳和血清免疫固定电泳在骨髓瘤肾病诊断和鉴别诊断中的敏感性和准确性。方法　对 4 1份骨髓瘤肾病和 36份其他肾功能损害患者的血清标本 ,采用血清免疫球蛋白定量、血清蛋白电泳和血清免疫固定电泳同时进行检测 ,求其单克隆免疫球蛋白的检出率 ,并将结果用SPSS10 0统计软件进行分析 ,以此来评价方法的敏感性和准确性。结果　免疫球蛋白定量不能检出单克隆成分 ;血清蛋白电泳对IgG和IgM型骨髓瘤检出率达 10 0 % ,其他型有较大缺陷 ,准确性及假阳性率无法判定。除不分泌型骨髓瘤外 ,免疫固定电泳对表现为肾功能损害的各型骨髓瘤检出率达 10 0 % ,准确性 10 0 % ,对照组无一假阳性。对照组与骨髓瘤肾病组比较差异有显著意义 (P <0 0 1)。 3种方法进行两两比较 ,相互间差异均有显著意义 (P <0 0 1)。结论血清免疫固定电泳较血清蛋白电泳和血清免疫球蛋白定量 ,在诊断和鉴别诊断骨髓瘤肾损害中有较高的敏感性和准确性 ,应作为肾脏疾病的常规检查项目在临床使用。 Objective To evaluate the sensitivity and accuracy of serum immunoglobulin quantitation, serum protein electrophoresis and serum immunoelectrophoresis in the diagnosis and differential diagnosis of myeloma and nephropathy. Methods The serum samples of 41 patients with myeloma and 36 patients with other renal impairment were detected by serum immunoglobulin, serum protein electrophoresis and serum immunoelectrophoresis simultaneously, and the detection rate of monoclonal immunoglobulin , And the results with SPSS10 0 statistical software analysis, in order to evaluate the sensitivity and accuracy of the method. Results The monoclonal antibody could not be detected by immunoglobulin quantitation. The detection rate of IgG and IgM myeloma was 100% by serum protein electrophoresis. The other types had larger defects. The accuracy and false positive rate could not be determined. In addition to non-secreting myeloma, the immune fixed electrophoresis showed that the detection rate of various types of myeloma with renal dysfunction was 100% and the accuracy was 100%. There was no false positive in the control group. There was significant difference between control group and myeloma nephropathy group (P <0.01). All three methods were compared with each other, the differences were significant (P <0.01). Conclusion Compared with serum protein electrophoresis and serum immunoglobulin, serum immunoelectrophoresis is more sensitive and accurate in the diagnosis and differential diagnosis of myeloma and should be used clinically as routine examination of renal disease.