血清同型半胱氨酸、乳酸脱氢酶、白细胞介素-17水平在急性白血病中的变化及意义

Changes of serum homocysteine,lactate dehydrogenase and interleukin-17 levels in acute leukemia and their significance

目的分析血清同型半胱氨酸(Hcy)、乳酸脱氢酶(LDH)和白细胞介素-17(IL-17)与急性白血病(AL)临床特征、近期疗效的相关性。方法选取95例AL患者作为研究组,另选取同期95例健康志愿者作为对照组。比较2组一般资料以及Hcy、LDH和IL-17水平。比较研究组不同临床特征患者的血清Hcy、LDH、IL-17水平。分析血清Hcy、LDH和IL-17水平与AL临床特征的关系。比较AL患者治疗前后血清Hcy、LDH、IL-17水平及其变化值(以△表示对应指标治疗前后变化值的绝对值),并分析血清Hcy、LDH、IL-17水平变化值与AL近期疗效的相关性。结果研究组血清Hcy、LDH和IL-17水平[(14.36±3.24)μmol/L、(591.42±113.85)U/L和(9.64±3.01)pg/mL]高于对照组[(9.75±2.08)μmol/L、(120.81±20.64)U/L和(4.08±1.25)pg/mL],差异有统计学意义(P<0.05)。研究组危险分层高风险患者血清Hcy、LDH和IL-17水平[(15.83±3.10)μmol/L、(636.19±110.54)U/L和(10.62±2.96)pg/mL]高于低中风险患者[(12.58±2.71)μmol/L、(537.28±95.68)U/L和(8.45±2.29)pg/mL],有髓外浸润患者血清Hcy、LDH和IL-17水平[(16.12±3.15)μmol/L、(647.59±115.46)U/L和(11.05±3.04)pg/mL]高于无髓外浸润患者[(13.38±2.89)μmol/L、(560.11±97.25)U/L和(8.85±2.65)pg/mL],差异有统计学意义(P<0.05)。研究组血清Hcy、LDH、IL-17水平与AL危险分层、髓外浸润呈正相关(P<0.05);研究组疗效不良患者治疗前后的血清Hcy、LDH和IL-17水平高于疗效良好患者,△Hcy、△LDH和△IL-17小于疗效良好患者,差异有统计学意义(P<0.05)。研究组△Hcy、△LDH和△IL-17与AL近期疗效呈正相关(P<0.05)。结论血清Hcy、LDH、IL-17水平与AL危险分层、髓外浸润呈正相关,且各指标治疗前后变化值与AL近期疗效呈正相关。

Objective To analyze the correlations of serum homocysteine(Hcy),lactate dehydrogenase(LDH)and interleukin-17(IL-17)levels with the clinical characteristics and short-term efficacy of acute leukemia(AL).Methods Ninety-five AL patients were selected as study group,and another 95 healthy volunteers during the same period were chosen as control group.The general information and levels of Hcy,LDH and IL-17 were compared between the two groups.The serum levels of Hcy,LDH and IL-17 were compared among patients with different clinical characteristics in the study group.The relationship between serum Hcy,LDH and IL-17 levels and the clinical features of AL was analyzed.The serum levels of Hcy,LDH and IL-17 before and after treatment,as well as their change values(△indicating the absolute value of the change in the corresponding indicator before and after treatment)were compared among AL patients.The correlation of the changes in serum Hcy,LDH and IL-17 levels with the short-term efficacy of AL was analyzed.Results The serum levels of Hcy,LDH,and IL-17 in the study group[(14.36±3.24)μmol/L,(591.42±113.85)U/L and(9.64±3.01)pg/mL,respectively]were significantly higher than those in the control group[(9.75±2.08)μmol/L,(120.81±20.64)U/L and(4.08±1.25)pg/mL,respectively](P<0.05).In the study group,patients at high risk of stratification had significantly higher serum levels of Hcy,LDH and IL-17[(15.83±3.10)μmol/L,(636.19±110.54)U/L and(10.62±2.96)pg/mL,respectively]compared to patients at low and medium risk[(12.58±2.71)μmol/L,(537.28±95.68)U/L and(8.45±2.29)pg/mL,respectively].Patients with extramedullary infiltration had significantly higher serum levels of Hcy,LDH,and IL-17[(16.12±3.15)μmol/L,(647.59±115.46)U/L and(11.05±3.04)pg/mL,respectively]compared to patients without extramedullary infiltration[(13.38±2.89)μmol/L,(560.11±97.25)U/L and(8.85±2.65)pg/mL,respectively](P<0.05).There was a positive correlation of serum levels of Hcy,LDH,and IL-17 with the risk stratification and extramedullary infiltration of AL in the study group(P<0.05).Patients with poor treatment response in the study group had significantly higher serum levels of Hcy,LDH and IL-17 before and after treatment compared to patients with a good treatment response,and△Hcy,△LDH and△IL-17 were significantly smaller than those of patients with a good treatment response(P<0.05).There were positive correlations between△Hcy,△LDH and△IL-17 and the short-term efficacy of AL in the study group(P<0.05).Conclusion The serum levels of Hcy,LDH and IL-17 are positively correlated with the risk stratification and extramedullary infiltration of AL,and the changes in these indicators before and after treatment are positively correlated with the short-term efficacy of AL.