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目的探讨同型半胱氨酸(p-Hcy)、超敏C反应蛋白(hs-CRP)、乳酸脱氢酶(LDH)及肿瘤特异性生长因子(TSGF)在儿童急性淋巴细胞白血病(ALL)患者外周血中的表达及临床意义。方法郑州大学第一附属医院2009年1月至2010年7月儿科血液病区收治的ALL患儿68例,其中男36例,女32例。所有患儿确诊后均进行正规化疗,其中完全缓解56例(缓解组),复发12例(复发组)。另选取门诊健康体检儿童46名作为对照组。测定ALL患儿化疗前、缓解后、复发后及对照组儿童外周血p-Hcy、hs-CRP、LDH和TSGF。结果缓解组化疗前和缓解后p-Hcy、hs-CRP、LDH和TSGF高于对照组,且缓解后低于化疗前,差异均有统计学意义(P值分别为<0.01、<0.05)。复发组复发后各项指标高于缓解组缓解后和对照组,差异有统计学意义(P<0.05),但与缓解组化疗前比较,差异无统计学意义(P>0.05)。缓解组化疗前p-Hcy与TSGF呈正相关(r=0.72,P<0.05),p-Hcy与LDH呈正相关(r=0.82,P<0.01),p-Hcy与hs-CRP呈正相关(r=0.82,P<0.01)。结论动态监测外周血中p-Hcy、LDH、hs-CRP及TSGF的表达,于明确儿童ALL化疗疗效及辅助诊断有一定参考价值。
Objective To investigate the effects of homocysteine (hcy), hs-CRP, LDH and TSGF in children with acute lymphoblastic leukemia (ALL) Expression of Peripheral Blood and Its Clinical Significance. Methods The First Affiliated Hospital of Zhengzhou University from January 2009 to July 2010 were admitted to Pediatric Hematology Ward 68 cases of ALL children, including 36 males and 32 females. All patients were diagnosed after formal chemotherapy, of which 56 cases of complete remission (remission group), 12 cases of recurrence (recurrence group). Another 46 out-patient health check-up children as a control group. The levels of p-Hcy, hs-CRP, LDH and TSGF in peripheral blood of children with ALL before and after remission, relapse and control group were determined. Results The levels of p-Hcy, hs-CRP, LDH and TSGF in the remission group were significantly higher than those in the control group before and after chemotherapy, and the difference was statistically significant before and after remission (P <0.01 and <0.05, respectively). The relapse group relapsed after the index was higher than the remission group and the control group, the difference was statistically significant (P <0.05), but compared with the remission group before chemotherapy, the difference was not statistically significant (P> 0.05). There was a positive correlation between p-Hcy and TSGF (r = 0.72, P <0.05), p-Hcy and LDH (r = 0.82, 0.82, P <0.01). Conclusion The dynamic monitoring of the expression of p-Hcy, LDH, hs-CRP and TSGF in peripheral blood has some reference value for the clear diagnosis of children with ALL chemotherapy.