急性白血病血清急相蛋白的临床意义

CLINICAL SIGNIFICANCE OF SERUM ACUTE PHASE PROTEINS IN ACUTE LEUKEMIA

分析了５种血清急相蛋白在２２例初治急性白血病患者的临床意义。结果表明：治疗前白血病患者Ｃ反应蛋白（ＣＲＰ），α＿１－酸性糖蛋白（α＿１－ＡＧ）明显高于正常（Ｐ＜０．００１）。α＿１－抗胰蛋白酶（α＿１－ＡＴ）、α＿２－巨球蛋白（α＿２－Ｍ）及β＿２－微球蛋白（β＿２－ＭＧ）与正常对照无差异（Ｐ＞０．０５）。白血病患者ＣＲＰ又明显高于非恶性血液病患者（Ｐ＜０．０１）。完全缓解后ＣＲＰ、α＿１－ＡＧ、α＿１－ＡＴ、β＿２－ＭＧ下降至正常，明显低于未缓解者。急相蛋白在未缓解者仍持续高于正常。α＿１－ＡＧ与α＿１－ＡＴ的水平与外周血白细胞数相关。认为血清急相蛋白特别是ＣＲＰ其次为α＿１－ＡＧ和α＿１ＡＴ对鉴别恶性与良性血液病有一定意义，动态观察能反映白血病细胞负荷及预测其治疗转归。

We analysed the clinical signmcance of five kinds of serum acute phase proteins in 22 cases ofnewly diagnosed acute leukemia。 The results showed that before treatment,the C-reactiveprotein(CRP) and α_1-acid glycoprotein(α_1-AG )in leukemic patients were significantly higherthan that of controls(P< 0. 001).There were no stutistical difference in α _2-macroglobulin( α_2-M),α_1-antitrypsin(α_1-AT)and β_2-microglobulin(β_2-MG ) ( P>0. 05 ).The CRP of leukemiccases was also significantly higher than that of nonmalignant blood disease cases(P<0. 01).After complete remission,CRP,α_1-AG ,α_1-AT and β_2-MG were decreased to normal,obviouslylower than those of non-responders. The acute phase proteins in non-remission cases werepersistently higher than those in responders.The levels of α_1-AG and α_1-AT correlated with theperipheral white blood cell count. We consider that acute phase proteins, particularly CRP,inthe next place the α_1-AG and α_1-AT might be of value in differentiating malignant and non-malignant blood disorders,and their kinetic studies might reflect the leukemic cell mass and couldpredict the therapeutic outcomes.