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目的 :探讨急性淋巴细胞白血病患儿血清 TNFa、s TNFR- 和 s TNFR- 水平及其临床意义。方法 :采用 EL ISA法测定血清 TNFa、s TNFR- 和 s TNFR- 水平。结果 :2 4例 AL L患儿血清 TNFα〔(173.2 2±74.5 1) ng/L〕明显高于 2 0例正常对照儿童〔(78.5 9± 18.45 ) ng/L〕,初发与复发患儿血清 s TNFR- 〔(2 .76±1.0 5 )、(2 .44± 1.37) μg/L〕、s TNFR- 〔(2 .33± 1.18)、(2 .0 9± 1.2 2 ) μg/L〕明显高于正常儿童〔(0 .75± 0 .2 6 )、(0 .71± 0 .14) μg/L〕,均为 P <0 .0 1;血清 TNFα与 s TNFR- 呈显著性正相关 (r =0 .6 31,P <0 .0 1) ;8例患儿经有效治疗完全缓解后血清 s TNFRs均降至正常水平〔(0 .83± 0 .2 5 )、(0 .92± 0 .17) μg/L〕;血清 s TNFRs在WBC≥ 10 0× 10 9/L患儿的阳性率明显高于 WBC<10 0× 10 9/L者 (P <0 .0 1) ,其与外周血幼稚细胞数呈显著正相关 (R =0 .72 4 ,R =0 .582 ,P <0 .0 5)。结论 :AL L患儿血清 s TNFRs异常升高与白血病细胞有关 ,血清 s TNFRs水平可作为估计肿瘤负荷及治疗效果的一项指标。
Objective: To investigate the serum levels of TNFa, s TNFR - and s TNFR - in children with acute lymphoblastic leukemia and their clinical significance. Methods: The levels of serum TNFa, s TNFR - and s TNFR - were measured by ELISA. Results: Serum TNFα 〔(173.2 2 ± 74.5 1) ng / L〕 was significantly higher in 24 children with ALL than those in 20 normal children [(78.5 9 ± 18.45) ng / L〕 Serum levels of TNFR- [(2.76 ± 1.05), (2.44 ± 1.37) μg / L], TNFR- [(2.33 ± 1.18), (2.90 ± 1.2 2) μg / L 〕 Were significantly higher than those in normal children 〔(0.75 ± 0.26), (0.71 ± 0.14) μg / L〕, both P <0.01; serum TNFα and s TNFR- (R = 0.61, P <0.01). Serum s TNFRs in 8 children with complete remission after treatment were reduced to normal levels 〔(0.83 ± 0.25), (0 .92 ± 0.17) μg / L〕. The positive rate of serum TNFRs in children with WBC≥10 × 10 9 / L was significantly higher than those with WBC <10 × 10 9 / L (P <0.01) ), Which was positively correlated with the number of naive cells in peripheral blood (R = 0.72 4, R = 0.582, P <0.05). Conclusion: The abnormal increase of serum s TNFRs in children with AL is related to leukemia cells. The level of serum s TNFRs can be used as an index to evaluate tumor burden and therapeutic effect.