急性白血病患者血清乳酸脱氢酶与α羟丁酸脱氢酶水平的临床意义

摘要

目的 探讨急性白血病(AL)血清乳酸脱氢酶(LDH)与α羟丁酸脱氢酶(α-HBDH)的临床价值.方法 初诊AL患者231例(A组)中,143例为完全缓解(A1组),31例出现缓解后复发(A2组),A组根据白细胞数分为高白细胞(C1)组、白细胞正常(C2)组和低白细胞(C3)组.另设正常人群101例作为对照(B组).采用酶学法检测各组血清LDH和α-HBDH水平.结果 A组血清LDH和α-HBDH浓度为604.6 U/L和455.59 U/L,明显高于B组的194.93 U/L和144.48 U/L(P＜0.05)；A2组血清LDH和α-HBDH浓度为390.46 U/L和282.12 U/L,明显高于B组和A1组的221.25 U/L和163.76 U/L(P＜0.05).C1组血清LDH和α-HBDH浓度为785.83 U/L和584.26 U/L,明显高于C2组的466.17 U/L和363.41 U/L和C3组的318,43 U/L和246.5 U/L(P＜0.05).A组中,急性淋巴细胞白血病患者的血清LDH和α-HBDH浓度为992.01 U/L和757.33 U/L,明显高于急性髓细胞白血病患者的497.66 U/L和372.44 U/L(P＜0,05).结论 血清LDH和α-HBDH可作为AL诊治过程中判断病情变化和预测复发的参考指标.%Objective To investigate the clinical significance of serum lactic dehydrogenase (LDH) and crhydroxybutyrate dehydrogenase(α-HBDH) in the patients with acute leukemia(AL). Methods Of 231 newly diagnosed AL patients(group A), 143 cases were with complete remission (group A1) ,31 cases with relapsed(group A2). Group A was divided into high leukocyte(group C1). normal leukocyte( group C2) and low leukocyte group(C3). One hundred and one healthy people were taken as the controls( group B). Serum LDH and α-HBDH were measured using enzymatic methods. Results The median values of serum of LDH and α-HBDH in group A were 604. 6 U/L and 455. 59 U/L,respectively, which were higher than 194. 93 U/L and 144. 48 U/L in group B(P<0. 05). Serum LDH and α-HBDH in group A2 were 390. 46 U/L and 282. 12 U/L, which were higher than those in group B and 221. 25 U/L and 163. 76 U/L in group A1(P<0. 05). Serum LDH and α-HBDH in group C1 were 785. 83 U/L and 584. 26 U/L, which were higher than 466.17 U/L and 363. 41 U/L in group C2 and 318. 43 U/L and 246. 5 U/L in group C3(P<0. 05). In group A,serum LDH and α-HBDH in the cases with acute lymphoblastic leukemia were 992. 01 U/L and 757. 33 U/L, which were higher than 497.66 U/L and 372.44 U/L in those with acute myeloid leukemia (P<0. 05). Conclusion Serum levels of LDH and α-HBDH can be considered as the indicators for evaluating theraputic outcome and predicting the prognosis in the treatment of patients with AL.