儿童急性白血病缓解期微量元素和营养相关蛋白的变化

Changes of trace elements and nutritional proteins in children with acute leukemia at remission stage

目的探讨儿童急性淋巴细胞白血病和急性粒细胞白血病缓解期某些微量元素及营养相关蛋白的变化。方法应用原子吸收光谱法、散射比浊法、干化学法和化学发光法等，对上海儿童医学中心43例急性淋巴细胞白血病和19例急性粒细胞白血病缓解期患儿（缓解组）和30名体检正常儿童（正常对照组）红细胞计数、血红蛋白含量、血清总蛋白、白蛋白、铁、铁蛋白、转铁蛋白、乳酸脱氢酶、铜蓝蛋白、铜、锌及铜／锌比值等指标进行检测，并对缓解组和正常对照组之间的差异进行比较。结果缓解组与正常对照组相比，血清总蛋白（P=0．454）、铁（P=0．769）、转铁蛋白（P=0．903）和锌（P=0．343）差异均无统计学意义。缓解组血清铁蛋白（P=0．000）、乳酸脱氢酶（P=0．000）、铜蓝蛋白（P=0．000）、铜（P=0．002）和铜／锌比值（P=0．003）均显著高于正常对照组，而红细胞计数（P=0．000）、血红蛋白含量（P=0．000）和白蛋白（P=0．046）均显著低于正常对照组。缓解组中急性淋巴细胞白血病和急性粒细胞白血病相比，除乳酸脱氢酶（P=0．025）外，其他指标差异均无统计学意义（P均〉0．05）。结论在儿童急性淋巴细胞白血病和急性粒细胞白血病的疾病缓解期，血清中微量元素与营养相关蛋白含量正逐步恢复正常，重建原有的平衡状态。

Objective To investigate the changes of serum trace elements and nutritional proteins in children with acute lymphoblastic leukemia and acute myeloid leukemia at the stage of remission. Methods Erythrocyte count, hemoglobin, serum levels of total protein, albumin, iron, ferritin, transferrin, lactate dehydrogenase, ceruloplasmin, cuprum, zinc and their ratio were measured in 43 patients with acute lymphoblastic leukemia, 19 patients with acute myeloid leukemia at stages of remission （ remission groups）, and 30 healthy controls （ control group） enrolled from Shanghai Children＇s Medical Center using atomic absorption spectrometry, nophelometry assay, dry chemical method, and chemiluminescence method. The differences of these indicators between remission groups and control group were analyzed. Results Serum levels of total protein （ P = 0. 454）, iron （ P = 0. 769）, transferrin （ P = 0. 903 ）, and zinc （ P = 0. 343 ） were not signifieantly different between the remission groups and the control group. Serum levels of ferritin （ P = 0. 000 ）, lactate dehydrogenase （ P = 0. 000 ）, ceruloplasmin （ P = 0. 000）, euprum （P = 0. 002） , and Cu/Zn ratio （P = 0. 003 ） in the remission groups were significantly higher than those in eontrol group. On the contrary, erythrocyte count （ P = 0. 000）, hemoglobin （ P = 0. 000） and albumin （ P = 0. 046 ） were significantly lower in remission groups than those of control group. Serum levels of all detected indicators were not signifieantly different between the aeute lymphoblastie leukemia remission group and acute myeloid leukemia remission group （P 〉 0.05 ） except for lactate dehydrugenase （ P = 0. 025 ）. Conclusion At the remission stage of acute lymphoblastic leukemia and acute myeloid leukemia, serum levels of some trace elements and nutritional proteins gradually returned to normal, and the original balance is established again.