甲氨蝶呤对急性淋巴细胞白血病患儿β2微球蛋白、肝细胞生长因子表达的影响

Effect of methotrexate on the expression of β2-microglobulin and hepatocyte growth factor in patients with acute lymphoblastic leukemia

目的探讨甲氨蝶呤治疗急性淋巴细胞白血病的临床效果及对β2微球蛋白(β2-MG)、肝细胞生长因子(HGF)的影响。方法根据治疗方案的不同将95例急性淋巴细胞白血病患儿分为观察组(n=45)和对照组(n=50)。观察组给予高剂量甲氨蝶呤进行治疗,对照组给予常规剂量甲氨蝶呤进行治疗。比较两组患者的临床疗效、β2-MG水平、HGF水平、不良反应发生情况和生存情况。结果观察组患者的总缓解率为91.11%。观察组患者的临床疗效优于对照组(P﹤0.05)。治疗后,观察组患者的β2-MG、HGF水平均低于对照组,且观察组CR和PR患者的β2-MG、HGF水平均低于NR患者(P﹤0.05)。两组患者的不良反应主要为1~2级不良反应。两组患者的不良反应发生率、中位生存时间比较,差异均无统计学意义(P﹥0.05)。结论高剂量甲氨蝶呤治疗急性淋巴细胞白血病有较好的临床效果,能明显降低患者的血清β2-MG、HGF水平,且未增加不良反应。

Objective To investigate the clinical effect of methotrexate therapy in acute lymphoblastic leukemia treatment and its effects onβ2-microglobulin(β2-MG)and hepatocyte growth factor(HGF).Method A total of 95 children with acute lymphoblastic leukemia were divided into the observation group(n=45)and the control group(n=50)according to varying treatment options.The observation group was treated with high-dose methotrexate and the control group was treated with routine dose methotrexate.The effect,levels of indicators including serumβ2-MG and HGF,the incidence of adverse events and overall survival in the two groups were compared.Result The total response rate of the observation group was 91.11%,indicating the effect of the observation group was better than that of the control group(P<0.05).After treatment,theβ2-MG and HGF levels of the observation group were lower than those of the control group(P<0.05).After treatment,the levels ofβ2-MG and HGF of complete response(CR)and partial response(PR)patients in the observation group were lower than those of non-response(NR)patients(P<0.05).The grade of adverse events in the two groups were mainly 1-2,and there was no significant difference in the incidence of adverse events and median survival time between the two groups of patients(P>0.05).Conclusion High-dose methotrexate has a good effect on acute lymphocytic leukemia treatment,which can significantly reduce the levels of serumβ2-MG and HGF without increasing the risk of adverse events.