血清LDH,TBIL,IBIL和Hcy水平检测 在MA和MDS临床鉴别诊断中的作用研究

目的 探讨血清乳酸脱氢酶(LDH)、总胆红素(TBIL)、间接胆红素(IBIL)和同型半胱氨酸(Hcy)水平变化在巨幼细胞性贫血(MA)和骨髓增生异常综合征(MDS)鉴别诊断中的临床应用价值。方法 利用日立7600全自动生化分析仪测定40例MA患者、30例MDS患者及40例健康体检者(正常对照组)的血清LDH,TBIL,IBIL和Hcy水平,应用SPSS16.0统计学软件进行数据处理作回顾性分析比较。结果MA组LDH,TBIL,IBIL和Hcy四项生化指标水平明显高于MDS组和正常对照组,差异有统计学意义(P<0.01); MDS组LDH水平高于正常对照组,差异有统计学意义(P<0.01); MDS组TBIL,IBIL和Hcy与正常对照组比较差异无统计学意义(P>0.05)。MA组的LDH,TBIL,IBIL和Hcy升高的阳性率高于MDS组,其中LDH和Hcy最为显著,两组间四项生化指标升高的阳性率相比差异均有统计学意义(P<0.01)。结论 联合检测LDH,TBIL,IBIL和Hcy四项生化指标水平对MA和MDS的鉴别诊断具有一定的临床价值。

Research on Detecting Serum LDH,TBIL,IBIL and Hcy Levels in Clinical Differential Diagnosis of MA and MDS

Objective To investigate the serum lactate dehydrogenase(LDH),total bilirubin(TBIL)and indirect bilirubin(IBIL)and homocysteine(Hcy)levels change in megaloblastic anemia(MA)and myelodysplastic syndrome(MDS)in the differential diagnosis of the clinical application value.Methods Hitachi 7 600 automatic biochemical analyzer was applied to the determination of 40 patients with MA,30 with MDS patients and 40 healthy physical examination(normal control group)of serum LDH,TBIL,IBIL andHcy levels,and application SPSS16.0 statistical software for data processing were retrospectively analyzed.Results Ma group of LDH,TBIL,IBIL and Hcy four biochemical index level was significantly higher than thatof MDS group and normal control group(P<0.01).MDS group of LDH levels higher than normal control group(P<0.01).MDS group of TBIL,IBIL and Hcy,there was no statistically significant difference compared with normal control group(P>0.05).MA group of LDH,TBIL,IBIL,Hcy higher positive rate higherthan that of MDS group,LDH and Hcy was most significant,four biochemical indexes between the two groups compared to increase the positive rate of difference was statistically significant(P<0.01).Conclusion Joint detection of LDH,TBIL,IBIL and Hcy four biochemical index level of the differential diagnosis of MA and MDS has certain clinical value.