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目的:探讨儿童急性淋巴细胞白血病(ALL)患者不同时期血清LDH水平的变化及其临床意义。方法:回顾性分析我院2010年1月-2014年12月收治的90例儿童ALL患者,并抽选同期52例健康儿童作为对照组,采用酶法检测ALL患者初诊前、d19诱导缓解化疗后、ALL复发时及正常对照组的LDH值,分析LDH与ALL疾病进程的关系。结果:90例ALL患者初诊组血清LDH水平为684.70±906.57 U/L,89例d19化疗后组为233.83±39.53 U/L,其中13例ALL复发前经诱导缓解治疗d19的LDH水平为196.30±54.48 U/L,13例复发组为877.61±1230.69 U/L,52例对照组为202.59±54.09 U/L,初发ALL患者血LDH水平明显高于d19化疗后组和对照组,差异有统计学意义(P<0.01),13例ALL复发前d19诱导缓解后与复发时血清LDH水平相比,差异有统计学意义(P<0.01)。d19诱导缓解化疗后组患儿骨髓白血病细胞数百分比与ALL初诊组相比显著降低,差异有统计学意义(P<0.01)。骨髓白血病细胞百分比与血清LDH水平对于评估儿童ALL预后的影响是一致的,但二者不具有直线相关关系(P>0.05)。结论:血清LDH水平可有助于儿童ALL的诊断、疾病进展及预后评估。
Objective: To investigate the changes of serum LDH levels in children with acute lymphoblastic leukemia (ALL) and its clinical significance. Methods: A retrospective analysis of 90 patients with ALL in our hospital from January 2010 to December 2014 was retrospectively analyzed. Fifty-two healthy children in the same period were selected as control group. Enzyme-linked immunosorbent assay , ALL relapse and normal control group LDH value, analysis of the relationship between LDH and ALL disease progression. Results: Serum LDH level was 684.70 ± 906.57 U / L in the first trimester of 90 ALL patients and 233.83 ± 39.53 U / L in 89 patients after d19 chemotherapy. The LDH level of d19 in 13 ALL patients after induction of remission was 196.30 ± 54.48 U / L, 13 cases of recurrent group was 877.61 ± 1230.69 U / L, 52 cases of control group was 202.59 ± 54.09 U / L, the initial LDH level of serum LDH was significantly higher than that of d19 chemotherapy group and control group, the difference was statistically (P <0.01). The difference of serum LDH levels in relapse after the induction of remission of 13 cases with ALL was statistically significant (P <0.01). The percentage of myeloid leukemia cells in d19-induced remission group was significantly lower than that in the newly diagnosed group (P <0.01). The percentage of myeloid leukemia cells and serum LDH level were the same for assessing the prognosis of children with ALL, but there was no linear relationship between them (P> 0.05). Conclusion: Serum LDH level may be helpful for the diagnosis, prognosis and prognosis of childhood ALL.