Abstract:

Abstract：Objective　To detect the changes of the plasma homocysteine（p-Hcy），high-sensitivity C-reactive protein（hs-CRP），1actic dehydrogenase（LDH） and tumor specific growth factor（TSGF） determination in patients with acute lymphocytic leukemia（ALL） and its clinical significance. Methods　p-Hcy（enzymatic cycling assay），hs-CRP（turbidimetry respectively），LDH（automatic analyzer） and TSGF （with biochemistry）before treatment and after remission were measured between ALL children and normal children in Department of Pediatrics，Zhengzhou university's First Hospital from Jan. 2009 to Jul. 2010. Results　Before chemotherapy and after complete remission，p-Hcy，hs-CRP，TSGF and LDH levels in the ALL-CR patients were significantly higher than those in the controls（P < 0.01） .The level of p-Hcy，hs-CRP，TSGF and LDH after complete remission was lower than that before treatment（P < 0.05）.The level of p-Hcy，hs-CRP，TSGF and LDH after cancer recurrence was higher than that of normal children and after complete remission of ALL-CR children（P < 0.05）.p-Hcy level was significantly correlated with LDH，TSGF and hs-CRP level before chemotherapy of ALL-CR children（P < 0.01）. Conclusion　p-Hcy，hs-CRP，TSGF and LDH can be used as a reference marker in diagnosis，monitoring patients’condition and prognosis evaluation in acute lymphocytic leukemia of children.

Key words: acute lymphocytic leukemia, children, plasma homocysteine, high-sensitivity C-reactive protein, 1actic dehydrogenase , tumor specific growth factor

摘要：

探讨同型半胱氨酸（p-Hcy）、超敏C反应蛋白（hs-CRP）、乳酸脱氢酶（LDH）及肿瘤特异性生长因子（TSGF）在儿童急性淋巴细胞白血病（ALL）患者外周血中的表达及临床意义。方法　郑州大学第一附属医院2009年1月至2010年7月儿科血液病区收治的ALL患儿68例，其中男36例，女32例。所有患儿确诊后均进行正规化疗，其中完全缓解56例（缓解组），复发12例（复发组）。另选取门诊健康体检儿童46名作为对照组。测定ALL患儿化疗前、缓解后、复发后及对照组儿童外周血p-Hcy、hs-CRP、LDH和TSGF。结果　缓解组化疗前和缓解后p-Hcy、hs-CRP、LDH和TSGF高于对照组，且缓解后低于化疗前，差异均有统计学意义（P值分别为 < 0.01、 < 0.05）。复发组复发后各项指标高于缓解组缓解后和对照组，差异有统计学意义（P < 0.05），但与缓解组化疗前比较，差异无统计学意义（P > 0.05）。缓解组化疗前p-Hcy与TSGF呈正相关（r = 0.72，P < 0.05），p-Hcy与LDH呈正相关（r = 0.82，P < 0.01） ，p-Hcy与hs-CRP呈正相关（r = 0.82，P < 0.01）。结论　动态监测外周血中p-Hcy、LDH、hs-CRP及TSGF的表达，于明确儿童ALL化疗疗效及辅助诊断有一定参考价值。

关键词: 急性淋巴细胞白血病, 儿童, 同型半胱氨酸, 超敏C反应蛋白, 乳酸脱氢酶, 肿瘤特异性生长因子