非霍奇金淋巴瘤患者LDH和β_2-MG及ESR与疾病发展及临床预后的关系

Relationship between the level of LDH,β_2-MG,ESR and the development and the prognosis of NHL

目的 探讨血清乳酸脱氢酶（LDH）、β2微球蛋白（β2-MG）、血沉（ESR）与非霍奇金淋巴瘤（NHL）的发生、发展、治疗及预后的相关性和临床意义。方法 以50例各期非霍奇金淋巴瘤患者为观察组，其中Ⅰ期6例，Ⅱ期24例，Ⅲ期16例，Ⅳ期4例。无症状组（A组）18例，有症状组（B组）32例。骨髓浸润组10例，无骨髓浸润组40例。并以50名健康体检者为对照组。全部病例均采集清晨空腹静脉血检测LDH、β2-MG、ESR，采用秩和检验及）（2检验分析LDH、β2-MG、ESR与疾病发展及临床预后的关系。结果 非霍奇金淋巴瘤患者LDH、β2-MG、ESR表达均高于正常值，且Ⅲ-Ⅳ期患者的表达水平高于Ⅰ-Ⅱ期患者（P〈0．05）。有症状组LDH、β2-MG、ESR的表达高于无症状组，骨髓浸润组高于无骨髓浸润组（P〈0．05）。结论 LDH、β2-MG、ESR三项指标联合检测高表达者肿瘤负荷大、恶性程度高、疾病发展快、临床预后差。本研究为实现个体化治疗提供了可靠的临床依据，对化疗方案的制定、化疗周期的确定具有一定的参考价值。

Objective To explore the clinical significance and correlation among serum LDH, β2- MG,ESR and the occurrence, progress, treatment, prognosis in the patients with NHL. Methods Fifty patients with NHL constitnted investigated group, including 6 patients of stage Ⅰ , 24 of stage Ⅱ, 16 of stage Ⅲ and 4 of stage Ⅳ. According to the general symptom, the investigated group was divided into group A （without general symptom, n = 18） and group B（with general symptom, n =32）. According to the result of bone marrow puncture and biopsy, the investigated group was divided into group with infiltration （n = 10） and group without infiltration （n = 40）. At the same time, 50 healthy people who received medical exam in our hospital served as control group, including 26 males and 24 females. Fasting venous blood was collected in the morning for determining the levels of LDH, β2-MG and ESR. The relationships amorsg the level of LDH, β2-MG, ESR and the development and the prognosis of NHL were analyzed using rank sum test and β2 test. Results In NHL patients, the expression of LDH, β2-MG and ESR were higher than those in normal people （P 〈 0. 05 ）. There were statistically significant difference in the levels of LDH, β2-MG and ESR between the patients at stage Ⅰ - Ⅱ and the patients at stage Ⅲ- Ⅳ （P 〈 0. 05 ）. The patients of group B with NHL general symptoms or bone marrow invasion had higher levels of LDH, β2-MG and ESR than the patients of group A. Condnsion The patients with high levels of LDH, β2-MG and ESR have greater tumor load, higher malignant degree, faster development and poorer clinical prognosis. The present study can provide reiable clinical evidence for individualized treatment, and has certain reference value for the design of chemotherapy plans and cycle.