慢性粒细胞白血病患者细胞染色体表型与血清LDH、HBDH变化的临床意义

Clinical significance of the change of serum levels of LDH,HBDH and the chromosome phenotype in patients with chronic myelocytic leukemia

目的探讨慢性粒细胞白血病(CML)患者细胞染色体表型与血清乳酸脱氢酶(LDH)、γ-羟丁酸脱氢酶(HBDH)变化的临床意义。方法用生化法检测不同病期CML患者的血清LDH、HBDH,并取其骨髓有核细胞用R带分析法作染色体分析。结果CML加速期或急变期组复杂核型染色体出现频率及血清LDH、HBDH显著高于慢性期组,两组不同染色体表型患者间的LDH、HBDH无统计学差异。慢性期组复杂核型染色体患者的骨髓原幼细胞高于单纯Ph1+者。LDH、HBDH在加速期或急变期组与骨髓幼稚细胞均呈正相关,在慢性期组与外周血WBC呈正相关。结论CML患者的血清LDH、HBDH水平及复杂核型染色体出现频率与病情相关,血清酶、细胞核型联合检测有助于更准确地判断CML患者的病情及预后。

Objective To investigate the clinical significance of serum levels of lactate dehydrogenase （ LDH）, hydroxy-butyric dehydrogenase （HBDH） and the chromosome phenotype in patients with chronic myelocytic leukemia （CML）. Methods The serum concentrations of LDH and HBDH were indirectly detected by chemical method. Karyotyping was performed using R-banding technique. Results The higher levels of LDH and HBDH and the higher incidence of the complex abnormal chromosome were found in the acceleration phase or blast crisis CML than in the chronic phase CML. Serum LDH and HBDH levels had no difference between the two groups. The bone marrow blasts percentage was higher in CML patients with the complex abnormal chromosome than Ph^1＋. Serum LDH level had positive correlation with HBDH in all groups, LDH and HBDH had positive correlation with the bone marrow blasts in the acceleration phase or blast crisis CML and with the leukocyte count in peripheral blood in chronic phase CML. Conclusions The high serum LDH and HBDH levels and high incidence of the complex abnormal chromosome in acceleration phase or blast crisis CML patients closely relate with their pathogenetie condition. The test of the serum enzyme combination with karyotyping may be a sensitive indicator for the judgment of CML development and prognosis.