骨髓增生异常综合征患者细胞遗传学和血清LDH检测临床意义  

The Clinical Significance of Cytogenetic Analysis in Myeloydysplastic Syndrome

作　　者：罗鸣[1] 张广莲[1] 巴荣[1] 陆益龙[1] 朱彦[1] 

机构地区：[1]江苏大学附属医院血液科,镇江212000

出　　处：《中国医药导刊》2009年第2期201-202,204,共3页Chinese Journal of Medicinal Guide

基　　金：江苏省镇江市社会发展基金项目(编号:SH2005048)

摘　　要：目的:研究骨髓增生异常综合征(MDS)患者细胞遗传学异常表型及患者血清肿瘤标志酶水平与该类患者转归关系。方法:采用骨髓细胞直接法或24～48小时培养法制备染色体,用RHG技术进行核型分析,生化法检测患者血清LDH水平。结果:MDS患者异常染色体出现率46%.主要有+8、-7、5q-、11q-、20q-,并有复杂异常核型。RA患者异常核型组LDH水平虽高于正常核型组.但无统计学差异。RAEB和RAEB-t患者血清LDH水平明显高于RA患者,且骨髓内幼稚细胞数与患者血清LDH水平呈正相关。复杂异常核型MDS患者血清LDH水平明显高于核型正常者,且急性白血病转化率明显高于核型正常者。结论:MDS患者有异常核型并血清LDH水平升高者易转为急性白血病,异常染色体出现及高血清LDH与该类患者转归有直接关系,血清LDH水平结合核型分析对MDS患者预后判断有重要价值。Objective：To Acquired Clonal chromosomal abnormalities of MDS patients and explore the relationship of its chromosomal abnormalities and the serum lactate dehydrogenase（LDH） in the patients with MDS patients. Methods： Metaphase chromosomes were prepared using direct method and culture method. Karyotyping was performed using R-banding technique. the Serum LDI-1 concentration was tested by clinical Chemistry analyzer. Results： Abnormal chromosomes were detected 48%, including of ＋ 8, , 7,5q- , 11 q- ,20q- and with the complex abnormal chromosome. In RA patients the serum LDH concentration was no diffrienee between the cases with abnormal karyotypes and it with normal karyotypes. But RAEB 和 RAEB-t patients have the high level of LDH than MDS-RA patients,the serum LDH level have the positive correlation with infantility ceils too. the serum LDH concentration and the risk of leukemic transformation was higher in cases with abnormal karyo- types than it with normal karyotypes. Conclusions： MDS patients with abnormal karyotypes and high level of serum LDH easily transform into acute leukemia. We propose that the karyotypes and LDH score should improve cliniCal decision-making and facilitate proper risk stratification in clinical trials.

关 键 词：骨髓增生异常综合征 核型异常 LDH 预后 

分 类 号：R551.3[医药卫生—血液循环系统疾病]