【摘要】：目的探討急性淋巴細(xì)胞白血病(ALL)患者血清乳酸脫氫酶(LDH)和維生素D水平與其預(yù)后的關(guān)系。方法選取成人初治ALL患者63例為ALL組,行大劑量甲氨蝶呤治療并隨訪至少1年。并以同期健康查體志愿者30例為對(duì)照組。檢測(cè)比較兩組血清LDH和25-羥維生素D[25(OH)D]水平及同期急性生理和慢性健康評(píng)分(APACHEⅡ評(píng)分)。統(tǒng)計(jì)ALL組隨訪1年的生存預(yù)后。分析ALL患者血清LDH和25(OH)D水平與其APACHEⅡ評(píng)分及1年生存率的關(guān)系及其預(yù)測(cè)1年生存預(yù)后的價(jià)值。結(jié)果與對(duì)照組比較,ALL組治療前血清LDH水平和APACHEⅡ評(píng)分升高而血清25(OH)D水平則降低(P0.05)。與治療前比較,ALL組治療后3d和治療后1個(gè)月的血清LDH水平和APACHEⅡ評(píng)分降低而血清25(OH)D水平則升高(P0.05)。ALL組1年生存率為80.95%。與ALL組存活患者比較,ALL組死亡患者治療前后的血清LDH水平和APACHEⅡ評(píng)分升高而血清25(OH)D水平則降低(P0.05)。Spearman無(wú)條件相關(guān)分析結(jié)果顯示,ALL患者血清LDH水平與APACHEⅡ評(píng)分呈正相關(guān)(r=0.868,P0.05)而與1年生存率呈負(fù)相關(guān)(r=-0.892,P0.05),其血清25(OH)D水平與APACHEⅡ評(píng)分呈負(fù)相關(guān)(r=-0.705,P0.05)而與1年生存率呈正相關(guān)(r=0.826,P0.05)。ROC曲線分析結(jié)果顯示,ALL患者治療前、治療后3d和治療后1個(gè)月的血清LDH和25(OH)D水平聯(lián)合預(yù)測(cè)其1年生存預(yù)后的準(zhǔn)確性分別為88.89%、95.24%和98.41%。結(jié)論 ALL患者血清LDH和25(OH)D水平與病情相關(guān)且聯(lián)合預(yù)測(cè)患者預(yù)后的價(jià)值良好,可能作為ALL患者病情和預(yù)后評(píng)估的參考指標(biāo)。
[Abstract]:Objective to investigate the relationship between serum lactate dehydrogenase (LDH) (LDH) and vitamin D levels and prognosis in patients with acute lymphoblastic leukemia (ALL). Methods 63 newly diagnosed adult patients with ALL were selected as ALL group and treated with high dose methotrexate and followed up for at least one year. 30 healthy volunteers were used as control group. Serum levels of LDH and 25-hydroxyvitamin D [25 (OH) D] and acute physiological and chronic health scores (APACHE 鈪，

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