急性白血病患者血清MMP-2及MMP-9的检测及其临床意义

Clinical significance of serum matrix metalloproteinase-2 and 9 detection in acute leukemia

目的:检测急性白血病(acute leukemia,AL)患者不同发展阶段血清基质金属蛋白酶-2(MMP-2)及基质金属蛋白酶-9(MMP-9)水平,以探讨这些活性物质在AL的诊断、治疗及预后判断中的临床意义。方法:选择初诊AL患者60例,正常对照组40例,测定其血清MMP-2及MMP-9水平并对结果比较分析,并对AL患者进行治疗前、后不同阶段的动态检测;骨髓涂片在显微镜下按常规分类计数200个有核细胞,计算原始加幼稚细胞比例。结果:1AL组初诊时血浆MMP-2含量明显升高,与正常对照组比较差异有统计学意义(P<0.05);2AL组初诊时血浆MMP-9含量明显升高,与正常对照组比较差异有统计学意义(P<0.05)。3经过2-3个疗程的治疗后,达到完全缓解(CR)时,血清MMP-2及MMP-9含量恢复正常,与正常对照组比较差异无统计学意义(P>0.05)。4经过2-3个疗程的治疗后,未达到缓解[包括部分缓解(PR)和未缓解(NR)]时,上述因子与治疗前比较差异无统计学意义(P>0.05);5AL初诊患者治疗前血清MMP-2及MMP-9水平与骨髓原始加幼稚细胞数呈正相关(P<0.05,r=0.618和P<0.05,r=0.368)。结论:动态监测AL患者血清MMP-2及MMP-9水平,可作为白血病病情进展、疗效过程及判断预后的重要参考指标。

Objective： To assess the levels of serum MMP-2 and MMP-9 in patients with acute leukemia at different stages,and to explore their role in diagnosis treatment and prognosis. Methods： The MMP-2 and MMP-9 of 60 cases of acute leukemia and 40 normal controls were detected, and analyzed before and after treatment. The nucleate white cells were differentially counted in bone marrow smear.Results： Compared with normal control group,serum MMP-2 and MMP-9 were elevated before treatment in acute leukemia patients（P〈0.05）, but became normal after treatment and complete remission（CR）（P〉0.05）, however MMP-2and MMP-9 remained elevated in patients non- remission（NR） after treatment. There was positive correlation between the total number of primitive and young cells and the levels of MMP-2 and MMP-9 in acute leukemia. Conclusion：Dynamic monitoring of serum MMP-2 and MMP-9 in acute leukemia can provide an important index for early diagnosis,therapeutic efficacy and prognosis of acute leukemia in clinic.