急性白血病患者血清乳酸脱氢酶与α-羟丁酸脱氢酶变化的临床意义

目的研究血清乳酸脱氢酶(LDH)与α-羟丁酸脱氢酶(α-HBDH)的变化与急性白血病(AL)患者疗效、预后的关系。方法用全自动生化分析仪检测56例初发或复发AL患者治疗前后血清LDH与α-HBDH浓度。同时纳入健康体检者35例为健康对照组,观察比较2组LDH、α-HBDH含量。结果AL患者血清LDH及α-HBDH初发或复发时明显增高,与健康对照组比较差异有非常显著统计学意义(P<0.01);治疗后达完全缓解与部分缓解者LDH和α-HBDH含量下降,治疗前后比较差异有统计学意义(P<0.01);复发后较复发前有明显上升(P<0.01);外周血幼稚细胞绝对数与血清LDH和α-HB-DH含量呈正相关(r值分别为0.5587和0.5411,P<0.01)。结论动态检查血清LDH及α-HBDH变化有助于监测AL患者的病情变化,高水平血清LDH及α-HBDH提示预后差。

Clinical significance of serum lactic dehydrogenase and α-hyaroxybutyrate dehydrogenase in patients with acute leukemia

Objective To investigate the clinical significance of the changes of serum lactic dehydrogenase (LDH) and α-hydroxybutyrate dehydrogenase (α-HBDH) in patients with acute leukemia (AL).Methods The serum samples were collected from 56 patients with acute leukemia including 44 primary onset patients and 12 relapsed patients,and 35 healthy subjects were used as control group. LDH and α-HBDH were detected by enzymatic assay.Results The levels of LDH and α-HBDH were significantly higher in newly diagnosed patients and relapsed patients than those in control group (P<0.01). The concentrations of both enzymes were decreased in complete remission patients and partial remission patients after treatment,there was a significant difference before chemotherapy and after chemotherapy (P<0.01).The concentrations of LDH and α-HBDH were obviously increased after relapsing,as compared with those before replasing (P<0.01).The number of immature cells in peripheral blood was positively correlated with the levels of LDH and α-HBDH (r=0.558 7 and 0.541 1 respectively,P<0.01).Conclusion The dynamic detection of the levels of serum LDH and α-HBDH may contribute to observing the changes of diseases process in AL patients,and increased serum levels of LDH and α-HBDH may predict a poor prognosis.