急性白血病患者血清MMP-2及MMP-9的检测及其临床意义

目的:检测急性白血病(acute leukemia，AL)患者不同发展阶段血清基质金属蛋白酶-2（MMP-2）及基质金属蛋白酶-9（MMP-9）水平，探讨这些活性物质在AL的诊断、治疗及预后判断中的临床意义。方法:选择初诊AL患者60例，正常对照组40例，测定其血清MMP-2及MMP-9水平并对结果比较分析，并对AL患者进行治疗前、后不同阶段的动态检测。骨髓涂片在显微镜下按常规分类计数200个有核细胞，计算原始加幼稚细胞比例。结果:AL组初诊时血清MMP-2含量明显升高，与正常对照组比较有显著性差异(P<0.05)。 AL组初诊时血清MMP-9含量明显升高，与正常对照组比较有显著性差异(P<0.05)。AL髓外浸润患者组MMP-2与MMP-9水平明显高于无髓外浸润患者组，差异有统计学意义(P<0.05)。经过2~3个疗程的治疗后，达到完全缓解（CR）时，血清MMP-2及MMP-9 含量恢复正常，与正常对照组比较无显著差异(P>0.05)。经过2~3个疗程的治疗后，复发组患者血清MMP-2及MMP-9 含量明显高于正常对照组，比较差异有统计学意义(P<0.05)。经过2~3个疗程的治疗后，未达到缓解［包括部分缓解（PR）和未缓解（NR）］时，上述因子与治疗前比较差异无统计学意义(P>0.05)。AL初诊患者治疗前血清MMP-2及MMP-9水平与骨髓原始加幼稚细胞数呈正相关(P<0.05，r=0.618和P<0.05，r=0.368)。结论:动态监测AL患者血清MMP-2及MMP-9水平，可作为白血病病情进展、疗效过程及判断预后的重要参考指标。

Detection and clinical significance of serum matrix metalloproteinase -2 and matrix met-alloproteinase -9 in acute leukemia

Objective:To measure the levels of serum matrix metalloproteinase -2 and matrix metalloproteinase -9 in patients with acute leukemia,and to explore their significance in the diagnosis and clinical therapy of acute leuke-mia.Methods:The MMP -2 and MMP -9 of 60 acute leukemia patients and 40 health adults were detected and the results were analyzed.The nuclear cells were counted in bone marrow smear in 60 cases of acute leukemia patients. Results:Compared with normal control group,serum levels of MMP -2 and MMP -9 were elevated before treatment in acute leukemia patients(P <0.05).Compared with normal control group,the levels of MMP -2 and MMP -9 had no difference in acute leukemia after complete remission(CR)(P >0.05).The levels of MMP -2 and MMP -9 with extramedullary infiltration were significantly higher than without extramedullary infiltration before treatment in acute leukemia patients.Compared with AL patients before treatment,the levels of MMP -2 and MMP -9 had no difference in acute leukemia after non -remission(NR)(P >0.05).Compared with normal control group,the levels of MMP -2 and MMP -9 were elevated before treatment in relapsed acute leukemia patients(P <0.05).There was positive cor-relation between the total number of primary and naive cells and the levels of MMP -2 and MMP -9 in acute leuke-mia(P <0.05,r =0.618 and P <0.05,r =0.368).Conclusion:Monitoring the level of MMP -2 and MMP -9 in a-cute leukemia provided the evidence for early diagnosis,prevention and treatment of acute leukemia.