儿童急性白血病血清25羟维生素D3的水平及其临床意义

The level and clinical significance of serum 25-dihydroxy vitamin D3 in children with acute leukemia

目的通过检测儿童急性白血病(AL)血清25羟维生素D3的水平,并探讨其临床意义。方法用双抗体夹心酶联免疫吸附试验(ELISA)方法分别测定60例急性白血病患儿,其中30例急性淋巴细胞白血病(ALL)患儿和30例急性髓细胞白血病(AML)患儿在初诊未治前、缓解1个月后、缓解6个月后和对照组30例健康儿童血清25羟维生素D3的水平,并且对其进行比较。结果血清25羟维生素D3的水平:AL初诊未治组(30.95±6.32)nmol/L,AL缓解1个月组(51.32±14.62)nmol/L,AL缓解6个月组(40.13±9.92)nmol/L;ALL初诊未治组(30.51±13.81)nmol/L,ALL缓解1个月组(61.11±18.93)nmol/L,ALL缓解6个月组(44.43±12.60)nmol/L;AML初诊未治组(31.44±7.13)nmol/L,AML缓解1个月组(41.24±10.29)nmol/L,AML缓解6个月组(36.73±9.73)nmol/L;正常对照组(58.71±8.97)nmol/L。方差分析结果:AL、ALL和AML初诊未治疗组的血清25羟维生素D3的水平均明显低于正常对照组(P<0.05)。AL(初诊未治组、缓解1个月组、缓解6月组)和ALL(初诊未治组、缓解1个月组、缓解6个月组)各组间血清25羟维生素D3的水平差异有显著性(P<0.05),AL缓解1个月组和ALL缓解1个月组血清25羟维生素D3的水平与正常对照组差异无显著性;AL和ALL缓解6个月组血清25羟维生素D3的水平低于正常对照组(P<0.05)。AML三组的血清25羟维生素D3的水平均低于正常对照组(P<0.05);ALL与AML初诊未治组血清25羟维生素D3的水平无显著性差异;AL、ALL和AML在化疗过程中血清25羟维生素D3的水平都是先上升,之后又有所下降或者停止上升的趋势。结论动态监测血清25羟维生素D3的水平在儿童急性白血病不同的治疗阶段的变化能够作为判断病情的发展以及评估治疗后效果的一项指标。

Objective To detection the level of serum 25-dihydroxy vitamin D3 and to explore its clinical significance in childhood acute leukemia.Methods Matched samples of initial treatment（IT）, remission one month（R-1 ）,and remission six months（R-6）from 60 children with acute leukemia,among them 30 children with acute lymphoblastic leukemia （ALL）and 30 children with acute myeloid leukemia （AML）,as well as 30 samples from healthy children （control）were collected.Double antibody sandwich enzyme-linked immunosorbent assay technology （ELISA ） was used to detect the serum level of serum 25-dihydroxyvitaminD3.Results Serum25-dihydroxyvitaminD3levels：tthelevelwas（30.95±6.32） nmol/L in untreated group（AL）,the level was（51 .32 ±1 4.62）nmol/L in remission one month group （AL）,the level was （40.1 3 ±9.92）nmol/L in remission six month group（AL）,the level was （30.51 ±＆amp;nbsp;1 3.81 ）nmol/L in untreated group（ALL）,the level was（61 .1 2 ±1 8.93）nmol /L in remission one month group（ALL）,the level was （44.43 ±1 2.60）nmol/L in remission six month group（ALL）,the level was （31 .44 ±7.1 3）nmol /L in untreated group（AML）,the level was（41 .24 ±1 0.29）nmol /L in remission one month group（AML）,the level was （36.73 ±9.73）nmol/L in remission six month group（AML）,the level was （58.71 ±8.97）nmol/L in normal control group.The differences between untreated groups（AL、ALL）and normal control group had statistical significance （P〈0.05 ）;and the level had not statistical significance between remission one month groups（AL、ALL）and normal control group （P〈0.05 ）;the differences between the three groups of AML and normal control group had statistical significance （P〈0.05 ）.The serum level of 25-dihydroxy vitamin D3 in IT samples is significantly lower than that in control samples.The differences between untreated groups （ALL、AML）had not statistical significance.Acute leukemia,acute lymphoblastic leukemia and acute myelogenous leukemia during chemotherapy,the levels ofserum25-dihydroxyvitaminD3wentupfirst,thendecreasedorstoppedrising.Conclusions Thelevel of serum 25-dihydroxy vitamin D3 could become a kind of detection index of acute leukemia.In childhood acute leukemia in different stages of treatment,dynamic monitoring the levels of serum 25-dihydroxy vitamin D3 were contributed to judge development of disease and assess treatment effect.