目的:探讨急性髓系白血病(AML)患者采用DCAG方案化疗后血清同源盒基因A9(HOXA9)、可溶性E钙黏蛋白(SE-CAD)及Ⅲ型前胶原蛋白(PCⅢ)水平的变化及其与预后的关系。方法:回顾性分析2018年3月至2021年12月经本院确诊并收治的80例复发难治性...目的:探讨急性髓系白血病(AML)患者采用DCAG方案化疗后血清同源盒基因A9(HOXA9)、可溶性E钙黏蛋白(SE-CAD)及Ⅲ型前胶原蛋白(PCⅢ)水平的变化及其与预后的关系。方法:回顾性分析2018年3月至2021年12月经本院确诊并收治的80例复发难治性AML患者的资料,按照治疗方案不同将其分为DCAG组(n=40)与CAG组(n=40),对比治疗前后各组的临床疗效及HOXA9、SE-CAD、PCⅢ水平的变化;另按照临床疗效将所有患者分为缓解组(n=58)与未缓解组(n=22),通过单因素和多因素分析影响AML患者预后的危险因素;采用ROC曲线分析HOXA9、SE-CAD、PCⅢ三项单一指标及三者联合对预后的预测效能。结果:相比于治疗前,DCAG组与CAG组患者在治疗后的HOXA9、SE-CAD、PCⅢ水平均有所下降,但DCAG组患者各指标的改善效果明显优于CAG组,且DCAG组患者在治疗后的临床疗效显著优于CAG组(均P<0.05);多因素分析结果显示,骨髓原始细胞比率、HOXA9 m RNA、SE-CAD及PCⅢ水平升高是影响AML患者化疗疗效的独立危险因素(均P<0.05);ROC曲线分析显示,HOXA9 m RNA、SE-CAD及PCⅢ联合能够有效预测AML预后情况,其敏感度为84.80%、特异度为88.20%。结论:应用DCAG的化疗方案能够显著改善AML患者的HOXA9 m RNA、SE-CAD及PCⅢ水平;且这三项指标作为影响AML患者预后的危险因素,通过联合检测能够对AML患者的预后情况进行有效预测。展开更多
Background:Most congenital heart diseases(CHDs)have specific hemodynamics,including volume and pressure overload,as well as cyanosis and pulmonary hypertension,associated with anatomical abnormalities.Such hemodynamic...Background:Most congenital heart diseases(CHDs)have specific hemodynamics,including volume and pressure overload,as well as cyanosis and pulmonary hypertension,associated with anatomical abnormalities.Such hemodynamic abnormalities can cause activation of neurohormones,inflammatory cytokines,fibroblasts,and vascular endothelial cells,which in turn contribute to the development of pathologic conditions such as cardiac hypertrophy,fi brosis,and cardiac cell damages and death.Measuring biomarker levels facilitates the prediction of these pathological changes,and provides information about the stress placed on the myocardial cells,the severity of the damage,the responses of neurohumoral factors,and the remodeling of the ventricle.Compared to the ample information on cardiac biomarkers in adult heart diseases,data from children with CHD are still limited.Data sources:We reviewed cardiac biomarkers-specifi cally focusing on troponin as a biomarker of myocardial damage,amino-terminal procollagen type III peptide(PIIIP)as a biomarker of myocardialfi brosis and stromal remodeling,and B-type natriuretic peptide(BNP)/N-terminal proBNP as biomarkers of cardiac load and heart failure,by introducing relevant publications,including our own,on pediatric CHD patients as well as adults.Results:Levels of highly sensitive troponin I are elevated in patients with atrial septal defects(ASDs)and ventricular septal defects(VSDs).PIIIP levels are also elevated in patients with ASD,VSD,pulmonary stenosis,and Tetralogy of Fallot.Measurement of BNP and N-terminal proBNP levels shows good correlation with heart failure score in children.Conclusions:In the treatment of children with CHD requiring delicate care,it is vital to know the specifi c degree of myocardial damage and severity of heart failure.Cardiac biomarkers are useful tools for ascertaining the condition of CHDs with ease and are likely to be useful in determining the appropriate care of pediatric cardiology patients.展开更多
文摘目的:探讨急性髓系白血病(AML)患者采用DCAG方案化疗后血清同源盒基因A9(HOXA9)、可溶性E钙黏蛋白(SE-CAD)及Ⅲ型前胶原蛋白(PCⅢ)水平的变化及其与预后的关系。方法:回顾性分析2018年3月至2021年12月经本院确诊并收治的80例复发难治性AML患者的资料,按照治疗方案不同将其分为DCAG组(n=40)与CAG组(n=40),对比治疗前后各组的临床疗效及HOXA9、SE-CAD、PCⅢ水平的变化;另按照临床疗效将所有患者分为缓解组(n=58)与未缓解组(n=22),通过单因素和多因素分析影响AML患者预后的危险因素;采用ROC曲线分析HOXA9、SE-CAD、PCⅢ三项单一指标及三者联合对预后的预测效能。结果:相比于治疗前,DCAG组与CAG组患者在治疗后的HOXA9、SE-CAD、PCⅢ水平均有所下降,但DCAG组患者各指标的改善效果明显优于CAG组,且DCAG组患者在治疗后的临床疗效显著优于CAG组(均P<0.05);多因素分析结果显示,骨髓原始细胞比率、HOXA9 m RNA、SE-CAD及PCⅢ水平升高是影响AML患者化疗疗效的独立危险因素(均P<0.05);ROC曲线分析显示,HOXA9 m RNA、SE-CAD及PCⅢ联合能够有效预测AML预后情况,其敏感度为84.80%、特异度为88.20%。结论:应用DCAG的化疗方案能够显著改善AML患者的HOXA9 m RNA、SE-CAD及PCⅢ水平;且这三项指标作为影响AML患者预后的危险因素,通过联合检测能够对AML患者的预后情况进行有效预测。
文摘Background:Most congenital heart diseases(CHDs)have specific hemodynamics,including volume and pressure overload,as well as cyanosis and pulmonary hypertension,associated with anatomical abnormalities.Such hemodynamic abnormalities can cause activation of neurohormones,inflammatory cytokines,fibroblasts,and vascular endothelial cells,which in turn contribute to the development of pathologic conditions such as cardiac hypertrophy,fi brosis,and cardiac cell damages and death.Measuring biomarker levels facilitates the prediction of these pathological changes,and provides information about the stress placed on the myocardial cells,the severity of the damage,the responses of neurohumoral factors,and the remodeling of the ventricle.Compared to the ample information on cardiac biomarkers in adult heart diseases,data from children with CHD are still limited.Data sources:We reviewed cardiac biomarkers-specifi cally focusing on troponin as a biomarker of myocardial damage,amino-terminal procollagen type III peptide(PIIIP)as a biomarker of myocardialfi brosis and stromal remodeling,and B-type natriuretic peptide(BNP)/N-terminal proBNP as biomarkers of cardiac load and heart failure,by introducing relevant publications,including our own,on pediatric CHD patients as well as adults.Results:Levels of highly sensitive troponin I are elevated in patients with atrial septal defects(ASDs)and ventricular septal defects(VSDs).PIIIP levels are also elevated in patients with ASD,VSD,pulmonary stenosis,and Tetralogy of Fallot.Measurement of BNP and N-terminal proBNP levels shows good correlation with heart failure score in children.Conclusions:In the treatment of children with CHD requiring delicate care,it is vital to know the specifi c degree of myocardial damage and severity of heart failure.Cardiac biomarkers are useful tools for ascertaining the condition of CHDs with ease and are likely to be useful in determining the appropriate care of pediatric cardiology patients.
