血清乳酸脱氢酶水平与急性淋巴细胞白血病患儿危险度关系的研究

Study on the relationship between the serum lactate dehydrogenase levels and the risk of acute lymphoblastic leukemia

目的探讨急性淋巴细胞白血病(ALL)患儿初诊时血清乳酸脱氢酶(S-LDH)水平与危险度分层的关系。方法分析100例初治急性淋巴细胞白血病患儿高危组、中危组、低危组S-LDH水平,并将初治急性淋巴细胞白血病患儿按S-LDH水平分成三组,分别观察其化疗后3年总无事件生存(EFS)率。结果 100例患儿中低危组18例,中危组56例,高危组26例,三组S-LDH水平分别为(1 293.6±863.4)、(410.38±151.66)、(233.00±42.34)U·L^(-1),差异有统计学意义(P<0.05)。早期疗效不佳组和早期疗效良好组S-LDH水平分别为(1146.33±689.77)、(491.56±301.86)U·L^(-1),差异有统计学意义(P<0.05)。LHD低值组、中值组、高值组3年EFS率分别为95.0%、90.0%、85.0%,三组间差异无统计学意义(P>0.05)。结论S-LDH可以客观地反映儿童急性淋巴细胞白血病的危险度分层。

Objective To explore the relationship between the serum lactate dehydrogenase(S-LDH) levels and the risk of children diagnosed as acute lymphoblastic leukemia(ALL).Methods A total of 100 children diagnosed as ALL were analyzed in this study.All patients were assigned into high risk,moderate risk and low risk groups according to the classified criterion and the levels of S-LDH were compared among three groups.Kaplan Meier method was used to estimate three-year event-free survival(EFS) rates among different groups.Results In 100 patients,there were 18 low-risk cases(LR group),56 moderate-risk cases(MR group) and 26 high-risk cases(HR group).The S-LDH levels of HR group,MR group and LR group were(1 293.6 ± 863.4) U·L^(-1),(410.38 ± 151.66) U·L^(-1) and(233.00 ± 42.34) U·L^(-1),respectively; the difference among three groups was statistically significant(P < 0.05).The SLDH levels in the poor efficacy group(1 146.33 ± 689.77) U·L^(-1) were obviously higher than those of good efficacy group(491.56± 301.86) U·L^(-1)(P < 0.05).The 3-year EFS rates in low levels,the median and the high levels of S-LDH groups were 95.0%,90.0%,85.0%,respectively; there was no significant difference among three groups(P > 0.05).Conclusions The risk stratification of children diagnosed as acute lymphoblastic leukemia may be reflected objectively by S-LDH levels.