急性白血病患者MCP-1、CCR-2及凝血功能指标的检测分析

Detection and analysis of MCP-1,CCR-2 and coagulation indexes in patients with acute leukemia

目的探讨急性白血病(AL)患者血清单核细胞趋化蛋白-1(MCP-1)、CC类趋化因子受体-2(CCR-2)及凝血功能指标的检测及临床意义。方法选取2016年1月至2017年12月成都医学院第一附属医院和贵州医科大学附属医院收治的AL患者100例和同期体检健康者50例,检测所有研究对象血液中MCP-1、CCR-2含量表达;检测所有研究对象血液凝血功能指标变化。结果与对照组相比,急性淋巴细胞白血病(ALL)组和急性髓细胞白血病(AML)组MCP-1、CCR-2水平明显升高,ALL组MCP-1、CCR-2水平升高更为明显,差异有统计学意义(P<0.05)。与治疗前相比,ALL组和AML组患者化疗后体内MCP-1、CCR-2水平显著降低,差异有统计学意义(P<0.05)。与对照组相比,ALL组和AML组血浆纤维蛋白原(FIB)、血浆D-二聚体(D-D)、凝血酶原时间(PT)、凝血酶原时间国际标准化比值(PT-INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)显著上升,抗凝血酶(ATⅢ)显著下降,差异具有统计学意义(P<0.05)。与治疗前相比,ALL组和AML组患者化疗后血浆FIB、D-D、PT、APTT、TT时间显著降低,差异有统计学意义(P<0.05),ATⅢ显著延长,差异有统计学意义(P<0.05),PT-INR没有显著改变,差异无统计学意义(P>0.05)。血浆FIB、D-D、ATⅢ、PT、APTT、TT与白血病治疗前后呈显著的正性相关关系(P<0.05);PT-INR白血病治疗前后无显著的相关性(P>0.05)。结论动态监测MCP-1、CCR-2及凝血功能指标变化有助于临床预测、判断AL患者的病情变化及评估治疗效果,可作为病情的判断及治疗的参考指标。

Objective To investigate the detection and clinical significance of monocyte chemoattractant protein-1(MCP-1),CC chemokine receptor-2(CCR-2)and coagulation function in patients with acute leukemia(AL).Methods From January 2016 to December 2017,100 patients with AL admitted to the First Affiliated Hospital of Chengdu Medical College and the Affiliated Hospital of Guizhou Medical University and 50 healthy people in the same period were selected to detect the expression of MCP-1 and CCR-2 in the blood of patients and the change of blood coagulation function indexes.Results Compared with the control group,the levels of MCP-1 and CCR-2 in patients with acute lymphoblastic leukemia(ALL)and acute myeloid leukemia(AML)were significantly higher,and the levels of MCP-1 and CCR-2 in ALL group were more significantly higher(P<0.05).Compared with that before treatment,the levels of MCP-1 and CCR-2 in all group and AML group were significantly lower after chemotherapy(P<0.05).Compared with patients in the control group,plasma fibrinogen(FIB),plasma D-dimer(DD),prothrombin time(PT),and international standard ratio of prothrombin time(PT-INR)in patients in the ALL group and AML group,activated partial thromboplastin time(APTT),and thrombin time(TT)increased significantly,and antithrombin(ATⅢ)decreased significantly(P<0.05).Compared with before treatment,the levels of FIB,D-D,Pt,APTT and TT in ALL group and AML group decreased significantly(P>0.05),ATⅢprolonged significantly(P<0.05)PT-INR level did not change significantly(P<0.05).There was a significant positive correlation between FIB,D-D,ATⅢ,PT,APTT,TT and leukemia before and after treatment(P<0.05).There was no significant correlation between PT-INR and leukemia before and after treatment(P>0.05).Conclusion The dynamic monitoring of MCP-1,CCR-2 and coagulation index is helpful for clinical prediction,evaluation of the disease status and treatment effect of AL patients,and can be used as a reference index for disease status judgment and treatment.