急性B淋巴细胞白血病儿童乳酸脱氢酶、前白蛋白及二者比值与化疗早期疗效的相关性

Correlations between lactate dehydrogenase,prealbumin,and their ratio and early chemotherapy efficacy in children with acute B-lymphoblastic leukemia

目的:探讨急性B淋巴细胞白血病(B-ALL)患儿乳酸脱氢酶(LDH)、前白蛋白(PA)及二者比值(LPR)与化疗早期疗效的相关性。方法:选取2020年5月至2022年5月我院收治的B-ALL患儿126例,观察患儿初诊时(化疗前,T0)、化疗第3 d(T1)、化疗第33 d(T2)的LDH、PA水平及LPR值。按照化疗第33 d微小残留病比例,将患儿分为疗效良好组(n=94)和疗效不良组(n=32),采用logistic回归分析化疗早期疗效的影响因素。结果:T1时患儿LDH及LPR低于T0,且T2低于T1(P<0.05);T2时PA高于T1(P<0.05)。临床危险度为高危、T0-WBC≥100×10~9/L、T0及T2时的LPR较高是患儿化疗早期疗效不良的危险因素(P<0.05)。结论:化疗后,B-ALL患儿LDH及LPR呈逐渐下降趋势,PA呈逐渐上升趋势,LPR与患儿化疗早期疗效具有相关性。

Objective:To explore the correlations between lactate dehydrogenase(LDH),prealbumin(PA),and LDH to PA ratio(LPR)and early chemotherapy efficacy in children with acute B-lymphoblastic leukemia(B-ALL).Methods:126 children with B-ALL admitted to our hospital from May 2020 to May 2022 were selected to observe the levels of LDH,PA,and LPR at the time of initial diagnosis(before chemotherapy/T0),on the third day of chemotherapy(T1),and on the 33rd day of chemotherapy(T2).According to the proportion of minimal residual disease on the 33rd day of chemotherapy,the patients were divided into a good efficacy group(n=94)and a poor efficacy group(n=32).Logistic regression was used to analyze the influencing factors of early chemotherapy efficacy.Results:The LDH and LPR of the children at T1 were lower than those at T0,and both were lower at T2 than those at T1(P<0.05);at T2,PA was higher than that at T1(P<0.05).The clinical risk classification of high-risk,T0-WBC≥100×10~9/L,and high LPR at T0 and T2 were risk factors for poor early chemotherapy efficacy in children(P<0.05).Conclusion:After chemotherapy,LDH and LPR in children with B-ALL show a gradually decreasing trend,while PA shows a gradually increasing trend.LPR is correlated with the early chemotherapy efficacy in children.