摘要：
目的 观察慢性粒细胞白血病(chronic myeloid leukemia, CML)患者血清环氧合酶-2(COX-2)、血管内皮生长因子(VEGF)及转化生长因子β1(TGF-β1)的水平变化,探讨各指标在临床中的指导意义.方法 选取我院2014年1月-2015年8月确诊的CML 50例(白血病组),予甲磺酸伊马替尼治疗3个月;同时选择在我院体检健康的40例(对照组).比较两组血清COX-2、VEGF及TGF-β1的水平变化,并观察白血病组治疗前后血清COX-2、VEGF及TGF-β1的变化.结果 与对照组比较,白血病组治疗前后血清COX-2及VEGF水平显著升高,TGF-β1水平显著降低,差异有统计学意义(P<0.01);与治疗前比较,白血病组治疗后血清COX-2、VEGF水平显著降低,TGF-β1水平显著升高,差异有统计学意义(P<0.01).白血病组治疗前急变期、加速期血清VEGF及COX-2水平均较慢性期显著升高,TGF-β1水平则降低,差异有统计学意义(P＜0.01);治疗后完全缓解(CR)者血清COX-2、VEGF及TGF-β1水平逐渐恢复正常,与未缓解(NR)者比较差异有统计学意义(P＜0.01).白血病组血清COX-2、VEGF水平与TGF-β1水平呈负相关(R=-0.632,P＜0.01;R=-0.315,P=0.026).结论 COX-2、VEGF及TGF-β1与CML患者病情密切相关,可作为CML病情评估的重要参考依据.%Objective To observe changes of serum cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) levels in patients with chronic myelogenous leukemia (CML) and to discuss guidance significance of indexes.Methods A total of 50 patients with CML confirmed during January 2014 and Augest 2015 (leukemia group) were treated with Imatinib Mesylate for 3 months, and other 40 healthy people taking medical examination were selected as control group.Changes of serum COX-2, VEGF and TGF-β1 levels were compared in two groups, and changes of the levels before and after treatment in leukemia group were observed.Results Compared with those in control group, before and after treatment, serum COX-2 and VEGF levels were significantly increased, while TGF-β1 level was significantly decreases in leukemia group (P<0.01);compared with those before treatment, in leukemia group, serum COX-2 and VEGF levels were significantly decreased;while TGF-β1 level was significantly increased after treatment (P<0.01).In leukemia group, before treatment serum VEGF and COX-2 levels were significantly increased, while TGF-β1 levels were significantly decreased in acute transformation phase and accelerated-phase compared with those in chronic-phase (P<0.01);after treatment, COX-2, VEGF and TGF-β1 levels of complete remission (CR) patients returned to normal, and the differences in the levels compared with those in non-remission (NR) patients were statistically significant (P<0.01).Serum COX-2 and VEGF levels were negatively correlated with TGF-β1 level in leukemia group (R=-0.632, P<0.01;R=-0.315, P=0.026).Conclusion COX-2, VEGF and TGF-β1 levels are closely related to conditions of patients with CML, and therefore they can be used as important revidence of disease for evaluating CML condition.
