白血病患者异基因造血干细胞移植术后血脂水平的变化

目的探讨白血病患者异基因造血干细胞移植术后血脂的变化及其原因。方法对62例白血病患者均采用静脉注射用马利兰联合环磷酰胺作为预处理方案进行了造血干细胞移植（HSCT），其中自体HSCT组（Auto—HSCT，对照组）20例，异基因HSCT组（Allo—HSCT，观察组）42例。对照组患者在移植后50d内，每周检测1次外周血胆固醇（CH）和甘油三酯（TG）的水平；观察组患者在移植后50d内每周同时检测一次外周血CH、TG和血浆环孢素A（CsA）浓度，50d后改为每月同时检测1次CH、TG和CsA浓度，直至停用CsA。观察两组患者移植过程中外周血CH和TG水平的变化，并分析观察组患者外周血CH、TG水平变化和CsA浓度之间的相关性。结果移植前，对照组和观察组患者的CH和TG平均浓度均正常，且两组之间差异无统计学意义（P〉0．05）；移植后50d内，对照组的CH和TG平均浓度与移植前比较无明显改变（P〉0．05），但观察组的CH和TG平均浓度较移植前明显升高（P〈0．05），且观察组CH、TG的平均浓度均明显高于对照组（P〈0．05）；观察组患者移植后的CH和TG平均水平与CsA浓度之间均存在相关性，相关系数分别为0．532（P〈0．05）和0．619（P〈0．05）。结论Allo—HSCT后血脂升高的原因主要由免疫抑制剂CsA引起，这种升高是暂时性的，随着CsA剂量递减，其血脂浓度逐渐降低，临床上一般不需降血脂药物治疗。

Changes of serum lipids in leukemia patients with allogeneic haemotopoietic stem cell transplantation

Objective To investigate the changes of serum lipids and its reason in leukemia patients with allogeneic haemotopoietic stem cell transplantation （ Allo - HSCT）. Methods Sixty - two patients with leukemia received Allo - HSCT （ n = 42, experimental group） and Auto - HSCT （ n = 20, control group） after conditioning regimen with busulfan and cyclophosphamide. Peripheral blood simples of all patients in control group were collected for detecting cholesterol（CH） and tri- glyceride（TG） once a week in 50 days after transplantation. The plasma concentrations of cyclosporine（CsA）, CH and TG in patients in experimental group were measured in the meantime once a week in 50 days after transplantation and once a month after 50 days until CsA was withdrawn. Investigate the alterations of concentrations of CH and TG between two groups in the process of transplantation and analyze the relationship between CH and TG levels and CsA concentrations in experimental group. Results The CH and TG concentrations in all patients of pre - transplantation were within the normal scope and there was no statistical difference in average concentrations of CH and TG between control group and experimental group （ P 〉 0.05 ）. Within fifty days after transplantation, the average concentrations of CH and TG in control group didn＇ t rise comparing to that of pre - transplantation （ P 〉 0.05 ）, but did in experimental group （ P 〈 0.05 ）. Most importantly, the average concentrations of CH and TG of post - transplantation in experimental group were higher apparently than that in control group（ P 〈 0.05 ）. As to the patients in experimental group, the average levels of CH and TG of post - transplantation were related to the concentrations of CsA and the correlation coefficients were 0. 532 （ P 〈 0.05 ） and 0. 619 （ P 〈 0.05 ） , respectively. Conclusions The increased levels of CH and TG after Allo - HSCT are due to the application of immune suppressor CsA. However, the duration of higher leve