恶性血液病患者血清sHLA-Ⅰ水平的变化及临床意义

目的探讨白血病、淋巴瘤、多发性骨髓瘤等恶性血液病患者体内可溶性人类白细胞抗原Ⅰ（sHLA-Ⅰ）水平的变化及其临床意义。方法用ELISA方法检测112例恶性血液病患者的血清sHLA-Ⅰ水平。结果血清8HLA．冰平白血病、多发性骨髓瘤、淋巴瘤均高于正常对照组（P均〈0．01），淋巴瘤、多发性骨髓瘤高于白血病（P均〈0．05），淋巴瘤组与多发性骨髓瘤组比较无统计学意义（P〉0．05）；白血病初治组、复发或未缓解组血清sHLA-Ⅰ水平高于缓解组（P均〈0．01），初治组与复发组比较无统计学意义（P〉0．05）。血清sHLA-Ⅰ水平与患者外周血乳酸脱氢酶及β2-微球蛋白水平有关。结论血清sHLA-Ⅰ可以作为一种辅助监测及判断恶性血液病预后及复发的指标。

Change of serum HLA-I level in patients with hematologic malignancies and its significance

Objective To investigate the clinical significance of the level of serum soluble human leukocyte antigens Ⅰ （sHLA-Ⅰ） in patients with acute leukemia, lymphoma or multiple myeloma. Methods Concentrations of serum sHLA-Ⅰ in 112 patients with acute leukemia, lymphoma multiple myeloma were determined by enzyme linked immunosorbent assay. Results Concentrations of serum sHLA-Ⅰ in acute leukemia, lymphoma multiple myeloma patients were significantly increased compared with normal control（ all P 〈 0.01 ）. The levels of sHLA-Ⅰ of Lymphoma and multiple myeloma patients were significantly higher than those of acute leukemia subjects （all P 〈 0.05 ）, but no difference was detected between lym- phoma and multiple myeloma（P 〉0.05）. The sHLA-Ⅰ levels in untreated and relapsed patients were significantly higher than those in the complete remission subjects（ all P 〈0.01 ） , while there was no difference between the untreated and relapsed patients significantly（P 〉 0.05）. The serum level of sHLA-Ⅰ was closely correlated with the peripheral leukocytes and contents of serum LDH as well as β2 macroglobulin. Conclusions Serum sHLA-Ⅰ can be as a prognosis and relapse index for malignant hemopathy.