恶性血液病患者唾液酸检测及临床意义

Detection of serum sialic acid in malignant blood disease and its clinical significance

目的测定血清唾液酸(SA)在恶性血液病患者的水平及评估临床意义。方法健康体检者60例及恶性血液病患者280例,其中急性髓系白血病(AML)50例、急性淋巴细胞白血病(ALL)20例、慢性髓性白血病(CML)50例、非霍奇金淋巴瘤(NHL)50例、多发性骨髓瘤(MM)病人110例,测定确诊时、治疗后的血清SA水平。结果各恶性血液病(除IgA型MM外)组血清SA与健康对照组比较无明显差异(P>0.05),各恶性血液病(除IgA型MM外)各组之间血清SA水平比较无明显差异(P>0.05),IgA型MM组血清SA显著高于健康对照组、各恶性血液病(除IgA型MM外)(P<0.01)。IgA型MM病人血清SA与球蛋白、骨髓涂片骨髓瘤细胞数、血沉、血清IgA呈正相关,与血清白蛋白、IgG、IgM、血红蛋白、血小板、β_2-微球蛋白呈负相关。IgA型MM病人血清SA与血清肌酐、乳酸脱氢酶、血清钙、C反应蛋白、白细胞无相关性。结论各恶性血液病(AML、ALL、CML、NHL、除IgA外的所有MM)患者血清SA均不明显高于健康人;仅IgA型MM的SA增高,血清SA是诊断IgA型MM的指标。是IgA型MM病人病情评估、反映肿瘤负荷量、疗效评价、监测疾病复发的指标。

Objective： To observe sialic acid in malignant blood disease and evaluate clinical significance. Methods： The level of serum SA in 60 healthy subjects and 280 patients with malignant blood disease were determined. 280 patients with malignant blood disease consisted of 50 patients with acute myeloid leukemia,20 patients with acute lymphoblastic leukemia,50 patients with chronic myeloid leukemia, 50 patients with non-hodgkin＇s lymphoma, 110 patients with multiple myeloma. Results ： Compared with those of healthy persons, all malignant blood disease patients other than IgA MM had no apparent difference （ P 〉 0.05 ）. There was no apparent difference among the serum sialie acid levels of acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, non-hodgkin＇s lymphoma, all MM patients other than IgA （ P 〉 0.05 ）. The serum sialic acids of IgA MM patients were obviously higher than those of healthy patients, all malignant blood disease patients other than IgA MM （P 〈 0.01 ）. The serum sialic acids of IgA MM patients had positive correlations with globulin, bone marrow smear myeloma cell population and ESR, serum IgA. The serum sialie acids of IgA MM patients had negative correlations with serum albumin, IgG, IgM, hemoglobinand, platelet, β2-mieroglobulin. The serum sialic acids of IgA MM patients had no correlation with serum ereatinine, lactic dehydrogenase, serum calcium, C-reactive protein and ,leukocyte（ P 〉 0.05 ）. Conclusion： Compared with those of healthy persons, all malignant blood disease patients other than IgA MM have no apparent difference. Only IgA type MM patients serum SA is high. The serum sialic acid is an index for diagnosis of IgA type MM, evaluating severity, reflecting the tumor load capacity, evaluating therapeutic efficiency of IgA MM patients and detecting dis-ease reeuIyenee.