慢性髓性白血病患者血清3-氨茴酰丙氨酸与尿酸水平检测的临床意义

Clinical Significance of Serum Kynurenine and Uric Acid Levels Detection in Chronic Myeloid Leukemia Patients

目的探讨慢性髓性白血病(CML)患者血清3-氨茴酰丙氨酸(KYN)与尿酸(UA)表达的临床意义。方法选取2014年3月~2015年12月收治的30例慢性髓性白血病患者(CML组)和25例健康体检者(对照组)。高效液相色谱法测定CML组和对照组血清中KYN和色氨酸(TRP),计算KYN/TRP比值(KTI);全自动血细胞分析仪检测白细胞;酶法检测血清尿酸;Pearson相关性分析UA与KTI和白细胞数相关性。结果治疗前CML组血清KTI(49.76±19.06)显著高于对照组(27.87±5.06,t=4.470,P=0.001)。ROC分析KTI cutoff值为40。CML组KTI与白细胞数相关(r=0.743,P=0.001),与年龄无关(r=0.205,P=0.276);10例KTI≥40的CML组患者治疗前KTI(64.7±17.8)和白细胞数[96.7±64.1)×10~9/L]显著高于治疗后KTI(27.0±10.9,t=7.102,P=0.001)和白细胞数[(10.1±5.2)×10~9/L,t=4.285,P=0.002];治疗前CML组KTI<40CML组患者(n=15)UA(354.98±103.9μmol/L)显著低于KTI≥40 CML组患者(n=15)UA(484.98±132.1μmol/L,t=1.432,P=0.045)。CML组UA与KTI(r=0.573,P=0.001)及白细胞数(r=0.537,P=0.002)相关。结论 CML患者KTI增加提示吲哚胺-2,3-双加氧酶(IDO)活性提高,IDO活性可能与CML发病和疗效相关,监测KTI可用于诊断CML和评价CML疗效。

Objective To investigate the clinical significance of kynurenine （KYN） and uric acid （UA） levels in chronic myeloid leukemia patients （CML）. Methods 30 CML patients （CML group） and 25 healthy controls （Control group） were enrolled in the hospital from Mar 2014 to Dec 2015. Serum KYN and tryptophan （TRP） of all subjects were determined by high performance liquid chromatography, and KYN/TRP ratio （KTI） were calculated. Leukocytes were counted by automat ic blood cell analyzer. Serum UA were detected by enzyme method. Correlation between UA and KTI, leukocytes were ana lyzed by Pearson correlation. Results The serum KTI of the CML group （49.76±19.06） before treatment was significantly higher than that of the control group （27.87±5.06,t=4. 470,P=0. 001）. KTI cutoff value was 40 by ROC analysis. There had correlation between KTI and leukocytes （r=0. 743, P= 0. 001） and no correlation between KTI and ages （r= 0. 205, P =0. 276）. KTI （64.7=17.8） and the leukocytes [（96.7±64.1） × 10^9/L] of 10 cases of KTI≥40 of CML patients before treatment was significantly higher than that of KTI （27.0!10.9,t=7. 102,P=0. 001） and the leukocytes[（10.1±5.2）× 10^9/L,t=4. 285,P=0. 002] after treatment. The serum UA in KTI=40 CML patients （n=lS, 354.98±103.9 =mol/L） was significantly lower than that of KTI=40 CML group CML （n=15, 484.98=132.1 9mol/L,t= 1. 432,P=0. 045）. The UA in CML group was associated with KTI （r=0. 573,P=0. 001） and leukocytes （r=0. 537,P=0. 002）. Conclusion The increase of KTI in CML patients suggested that an increased activity of indoleamine-2,3-dioxygenase （IDO）. IDO activity may associated with CML morbidity and therapy effect. The detection of KTI may contribute to the diagnosis of CML and assessing therapy effect of CML.