动态监测血清乳酸脱氢酶水平在急性白血病中的临床意义研究

目的通过动态监测急性白血病(AL)患者血清乳酸脱氢酶(LDH)水平,探讨LDH对AL患者病情监测和预后评估的临床意义。方法回顾分析初诊的1 184例AL患者的2 170例次LDH水平,评估患者LDH水平随疾病进程的变化趋势并探究其与AL的预后和疾病进展的关系,同时分析LDH与血细胞、骨髓白血病细胞比例、白血病融合基因和流式细胞术分型等相关辅助诊断指标的关系。结果 AL患者不同病程阶段的LDH水发平不同,其中初发组及复发组LDH水平明显高于缓解组及正常对照组(P0.05)。缓解组LDH水平有所减低,但仍高于正常对照组(P0.05)。急性淋巴细胞白血病(ALL)组LDH水平明显高于急性髓性白血病(AML)组(P0.05)。与其他AL诊断及预后相关指标比较,LDH与骨髓白血病细胞百分数、白血病相关融合基因、细胞免疫分型等都有相关性(P0.05)。结论不同病程阶段、不同亚型AL患者的血清LDH水平有差异,血清LDH水平可作为AL诊断、疾病进程及疗效评估的辅助指标。

Clinical significance on the dynamic monitoring of serum lactate dehydrogenase levels in acute leukemia

Objective To monitor dynamically serum lactate dehydrogenase （LDH）levels in acute leukemia （AL）patients,and to investigate the clinical significance on the monitoring of pathogenetic condition and prognosis evaluation.Methods The LDH levels of 2 1 70 times from 1 1 84 de novo AL patients were analyzed retrospectively. The relationship of LDH levels with disease progression and AL prognosis was evaluated.The relationships between LDH levels and blood cell counts,the proportion of bone marrow leukemia cells,cytogenetic abnormality,flow cytometry immunophenotyping and the other related diagnostic markers were analyzed.Results LDH levels of AL patients in different stages of the disease were different.The LDH levels of incipient and relapse stages in AL patients were significantly higher than those of remission stage in AL patients and those in healthy controls （P〈0.05 ）.The LDH levels of remission stage in AL patients reduced,but were still significantly higher than those in healthy controls （P〈0.05）.The LDH levels of acute lymphoblastic leukemia （ALL）patients were significantly higher than those of acute myeloid leukemia （AML）patients （P〈0.05 ）.Compared with the other diagnostic and prognostic indicators of AL, LDH levels had correlation with the proportion of bone marrow leukemia cells,cytogenetic abnormality and flow cytometry immunophenotyping （P〈0.05）.Conclusions The serum LDH levels of AL patients in different stages and different subtypes are different significantly.The LDH levels can be used as a supplementary indicator of AL diagnosis,disease progression and therapeutic effect evaluation.