急性髓细胞白血病和骨髓增生异常综合征患者血清β2微球蛋白检测的临床意义

 目的 动态观察骨髓增生异常综合征（MDS）及急性髓细胞白血病（AML）患者治疗缓解前后血清β2微球蛋白（β2-MG）水平，及其与患者分型、临床特点、疗效及预后的关系。方法 对30例MDS、80例AML患者及30例正常对照人群血清β2-MG进行测定并随访观察。结果 MDS组及AML组血清β2-MG值均明显高于正常对照组。其中MDS-RAEB2组β2-MG值明显高于MDS其他各型（P＜0.05）。AML各型β2-MG值差异无统计学意义，但升高多见于M4，M5的患者。52例AML患者缓解后血清β2-MG值明显低于治疗前。初发时外周血出现原始细胞及白细胞升高的AML患者血清β2-MG值明显高于无原始细胞及白细胞数正常的患者。此外，年龄超过60岁的患者血清β2-MG值也相对较高。结论 血清β2-MG值一定程度上反映了MDS及AML患者体内的肿瘤负荷，血清β2-MG值与外周血原始细胞数、白细胞数及年龄呈正相关关系。动态观察AML患者的血清β2-MG，结合临床其他资料，对判断病情、疗效、预后有一定实用价值。

The clinical significance of serum levels of β2 microglobulin in acute myelocytic leukemia and myelodysplastic syndrome

Objective To measure and monitor the β2 microglobulin (β2-MG) levels of MDS and AML patients before and after the remission. To analyze and study the relationship between β2-MG variation and clacification, stage, clinical features, response to the treatment as well as prognosis. Methods 30 MDS and 80 AML patients and 30 healthy volunteers as control subjects were enrolled in the current study. β2-MG levels in their serum were measured and monitored closely. Results It was demonstrated that β2-MG levels in the serum of MDS and AML patients were much higher than those of healthy controls. In particular, the β2-MG value of MDS-RAEB2 was much higher than that of other MDS types（P ＜0.05）. Although there was no significant difference in the β2-MG levels in various AML types, the M4 and M5 were much more likely to rise than other types. The β2-MG levels of 52 AML patients in complete remission were significantly lower than those be-fore treatment. The increased β2-MG levels were significantly related to the number of immature cells and white blood counts in peripheral blood of AML patients at diagnosis. Patients older than 60 years tended to have relatively higher serumβ2-MG levels. Conclusion Serum level of β2-MG was showed, to some extent, the load tumor of MDS and AML patients. Serum levels of β2-MG in MDS and AML patients were proportionally related to the number of immature cells, white blood cell counts in peripheral blood as well as patients' age. To monitor serumβ2-MG levels in AML patients combined with other clinic facts, will be proven to be of practical value to predict the response to the treatment as well as prognosis.