血清同型半胱氨酸、乳酸脱氢酶、白细胞介素-17水平在急性白血病中的变化及意义

Changes of serum homocysteine, lactate dehydrogenase and interleukin-17 levels in acute leukemia and their significance

  • 摘要:
    目的 分析血清同型半胱氨酸(Hcy)、乳酸脱氢酶(LDH)和白细胞介素-17(IL-17)与急性白血病(AL)临床特征、近期疗效的相关性。
    方法 选取95例AL患者作为研究组, 另选取同期95例健康志愿者作为对照组。比较2组一般资料以及Hcy、LDH和IL-17水平。比较研究组不同临床特征患者的血清Hcy、LDH、IL-17水平。分析血清Hcy、LDH和IL-17水平与AL临床特征的关系。比较AL患者治疗前后血清Hcy、LDH、IL-17水平及其变化值(以△表示对应指标治疗前后变化值的绝对值),并分析血清Hcy、LDH、IL-17水平变化值与AL近期疗效的相关性。
    结果 研究组血清Hcy、LDH和IL-17水平(14.36±3.24) μmol/L、(591.42±113.85) U/L和(9.64±3.01) pg/mL高于对照组(9.75±2.08) μmol/L、(120.81±20.64)U/L和(4.08±1.25) pg/mL, 差异有统计学意义(P < 0.05)。研究组危险分层高风险患者血清Hcy、LDH和IL-17水平(15.83±3.10) μmol/L、(636.19±110.54) U/L和(10.62±2.96) pg/mL高于低中风险患者(12.58±2.71)μmol/L、(537.28±95.68)U/L和(8.45±2.29) pg/mL, 有髓外浸润患者血清Hcy、LDH和IL-17水平(16.12±3.15)μmol/L、(647.59±115.46)U/L和(11.05±3.04)pg/mL高于无髓外浸润患者(13.38±2.89)μmol/L、(560.11±97.25)U/L和(8.85±2.65) pg/mL, 差异有统计学意义(P < 0.05)。研究组血清Hcy、LDH、IL-17水平与AL危险分层、髓外浸润呈正相关(P < 0.05); 研究组疗效不良患者治疗前后的血清Hcy、LDH和IL-17水平高于疗效良好患者, △Hcy、△LDH和△IL-17小于疗效良好患者,差异有统计学意义(P < 0.05)。研究组△Hcy、△LDH和△IL-17与AL近期疗效呈正相关(P < 0.05)。
    结论 血清Hcy、LDH、IL-17水平与AL危险分层、髓外浸润呈正相关,且各指标治疗前后变化值与AL近期疗效呈正相关。

     

    Abstract:
    Objective To analyze the correlations of serum homocysteine (Hcy), lactate dehydrogenase (LDH) and interleukin-17 (IL-17) levels with the clinical characteristics and short-term efficacy of acute leukemia (AL).
    Methods Ninety-five AL patients were selected as study group, and another 95 healthy volunteers during the same period were chosen as control group. The general information and levels of Hcy, LDH and IL-17 were compared between the two groups. The serum levels of Hcy, LDH and IL-17 were compared among patients with different clinical characteristics in the study group. The relationship between serum Hcy, LDH and IL-17 levels and the clinical features of AL was analyzed. The serum levels of Hcy, LDH and IL-17 before and after treatment, as well as their change values (△indicating the absolute value of the change in the corresponding indicator before and after treatment) were compared among AL patients. The correlation of the changes in serum Hcy, LDH and IL-17 levels with the short-term efficacy of AL was analyzed.
    Results The serum levels of Hcy, LDH, and IL-17 in the study group(14.36±3.24) μmol/L, (591.42±113.85) U/L and (9.64±3.01) pg/mL, respectivelywere significantly higher than those in the control group (9.75±2.08) μmol/L, (120.81±20.64) U/L and (4.08±1.25) pg/mL, respectively(P < 0.05). In the study group, patients at high risk of stratification had significantly higher serum levels of Hcy, LDH and IL-17 (15.83±3.10) μmol/L, (636.19±110.54) U/L and (10.62±2.96) pg/mL, respectively compared to patients at low and medium risk(12.58±2.71) μmol/L, (537.28±95.68) U/L and (8.45±2.29) pg/mL, respectively. Patients with extramedullary infiltration had significantly higher serum levels of Hcy, LDH, and IL-17(16.12±3.15) μmol/L, (647.59±115.46) U/L and (11.05±3.04) pg/mL, respectivelycompared to patients without extramedullary infiltration(13.38±2.89) μmol/L, (560.11±97.25) U/L and (8.85±2.65) pg/mL, respectively(P < 0.05). There was a positive correlation of serum levels of Hcy, LDH, and IL-17 with the risk stratification and extramedullary infiltration of AL in the study group (P < 0.05). Patients with poor treatment response in the study group had significantly higher serum levels of Hcy, LDH and IL-17 before and after treatment compared to patients with a good treatment response, and △Hcy, △LDH and △IL-17 were significantly smaller than those of patients with a good treatment response (P < 0.05). There were positive correlations between △Hcy, △LDH and △IL-17 and the short-term efficacy of AL in the study group (P < 0.05).
    Conclusion The serum levels of Hcy, LDH and IL-17 are positively correlated with the risk stratification and extramedullary infiltration of AL, and the changes in these indicators before and after treatment are positively correlated with the short-term efficacy of AL.

     

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