發(fā)布時(shí)間：2018-04-09 02:28

  本文選題：非霍奇金淋巴瘤　切入點(diǎn)：超氧化物歧化酶　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者血清超氧化物歧化酶(superoxide dismutase,SOD)的表達(dá)及其臨床意義,分析血清SOD活性與患者的性別、年齡、分型、國(guó)際標(biāo)準(zhǔn)化預(yù)后指數(shù)(international prognostic index,IPI)評(píng)分、臨床分期、血清乳酸脫氫酶(lactate dehydrogenase,LDH)等臨床病理參數(shù)及化療的關(guān)系,為NHL的臨床診療提供參考。方法:1.收集2015年1月至2016年12月在甘肅省人民醫(yī)院首診的NHL患者114例,包括64例彌漫大B細(xì)胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL),18例濾泡細(xì)胞淋巴瘤,4例間變大細(xì)胞淋巴瘤,2例套細(xì)胞淋巴瘤,18例NK-T細(xì)胞淋巴瘤,2例血管免疫母T細(xì)胞淋巴瘤,2例T細(xì)胞白血病/淋巴瘤,2例骨外漿細(xì)胞淋巴瘤,2例結(jié)外邊緣區(qū)MALT粘膜相關(guān)淋巴瘤;120例健康對(duì)照組來(lái)自同期甘肅省人民醫(yī)院體檢中心的健康體檢者。2.采用比色法(終點(diǎn)法)分別檢測(cè)健康對(duì)照組、NHL組及CHOP方案化療2周期后血清SOD活性,分析血清SOD活性的變化與NHL臨床病理參數(shù)及化療效果的關(guān)系。3.用SPSS19.0統(tǒng)計(jì)軟件對(duì)檢測(cè)結(jié)果進(jìn)行分析。結(jié)果:1.基線均衡性比較:NHL組和健康對(duì)照組之間年齡、性別比例無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。2.NHL組與健康對(duì)照組血清SOD活性比較有統(tǒng)計(jì)學(xué)差異(P0.05)。3.NHL患者血清SOD活性與臨床病理參數(shù)的關(guān)系:(1)NHL患者不同的年齡及性別血清SOD活性比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(2)NHL患者不同的分型、IPI評(píng)分、臨床分期血清SOD活性比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)NHL患者LDH正常組與異常組血清SOD活性比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.用CHOP方案化療2個(gè)療程后完全緩解患者與治療前患者血清SOD活性比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5.NHL患者血清SOD活性與血清LDH呈負(fù)相關(guān),r=-0.223,P0.05。6.根據(jù)ROC曲線分析,血清SOD曲線下面積為0.714,曲線下面積與零假設(shè)的實(shí)面積0.5比較差異有統(tǒng)計(jì)學(xué)意義。最佳分界點(diǎn)146.50U/ml是根據(jù)約登(Youden)指數(shù)測(cè)定的,靈敏度為75%,特異度為62.3%。結(jié)論:1.血清SOD活性降低可能參與了NHL的發(fā)生及病情演變過(guò)程。2.血清SOD活性可能對(duì)NHL的診斷有一定的參考價(jià)值。
[Abstract]:Objective: to investigate the expression and clinical significance of serum superoxide dismutase (SOD) in patients with non-Hodgkin 's lymphoma (non-Hodgkin 's lymphoma).The relationship between clinical pathological parameters and chemotherapy of serum lactate dehydrogenase and LDHs provides reference for clinical diagnosis and treatment of NHL.Method 1: 1.From January 2015 to December 2016, 114 patients with NHL were first diagnosed in Gansu Provincial people's Hospital.There are 64 cases of diffuse large B-cell lymphoma with diffused large B-cell lymphomatosis 18 cases of follicular cell lymphoma, 4 cases of anaplastic large cell lymphoma, 2 cases of anaplastic large cell lymphoma, 18 cases of NK-T cell lymphoma, 2 cases of vascular immunoblastic T-cell lymphoma and 2 cases of T cell white.Two patients with extraosseous plasmacytic lymphoma and two patients with MALT mucosa-associated lymphoma in the outer marginal region of the blood disease / lymphoma. 120 healthy controls were collected from the physical examination center of Gansu Provincial people's Hospital in the same period.The serum SOD activity was detected by colorimetric assay (endpoint method) in the healthy control group and after 2 cycles of chemotherapy with CHOP regimen. The relationship between the changes of serum SOD activity and the clinicopathological parameters of NHL and the effect of chemotherapy was analyzed.The test results were analyzed by SPSS19.0 software.The result is 1: 1.Baseline equilibrium comparison: age between the + NHL group and the healthy control group,There was no statistical difference in the sex ratio. 2. There was significant difference in serum SOD activity between the NHL group and the healthy control group. The relationship between the serum SOD activity and the clinicopathological parameters in the patients with NHL was not different from that in the control group. There was no significant difference in serum SOD activity between different ages and sexes in the patients with NHL.There were significant differences in IPI scores among different types of NHL patients.There was no significant difference in serum SOD activity between normal group and abnormal group in patients with LDH. There was no significant difference in serum SOD activity between normal group and abnormal group.There was a significant difference in serum SOD activity between patients with complete remission and patients before treatment after two courses of chemotherapy with CHOP regimen. There was a negative correlation between serum SOD activity and serum LDH in patients with complete remission and pre-treatment. There was a negative correlation between serum SOD activity and serum LDH.According to the analysis of ROC curve, the area under serum SOD curve was 0.714, and there was significant difference between the area under the curve and the real area of zero hypothesis.The optimal demarcation point 146.50U/ml was determined according to the Youden index with sensitivity of 75 and specificity of 62.3.Conclusion 1.The decrease of serum SOD activity may be involved in the pathogenesis and progression of NHL.The activity of serum SOD may have some reference value for the diagnosis of NHL.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R733.1

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