G6PD活性在急性白血病患儿中的变化及其临床意义  

Change of G6PD Activity in Children with Acute Leukemia and Its Clinical Significance

作　　者：苏琼 黄成双 吴柳松[1] 罗茜[1] 田润梅[1] 陈艳[1] SU Qiong;HUANG Cheng-Shuang;WU Liu-Song;LUO Xi;TIAN Run-Mei;CHEN Yan(Second Department of Pediatrics,Affiliated Hospital of Zunyi Medical College/The Children's Hospital of Guizhou Province,Zunyi 563003,Guizhou Province,China;Department of Pediatrics,Clinical Medicine Department of Zunyi Medical and Pharmaceutical College ,Zunyi563003,Guizhou Province,China)

机构地区：[1]遵义医学院附属医院/贵州省儿童医院儿内二科,贵州遵义563003 [2]遵义医药高等专科学校临床医学系儿科教研室,贵州遵义563003

出　　处：《中国实验血液学杂志》2018年第6期1649-1656,共8页Journal of Experimental Hematology

基　　金：国家自然科学基金(81370612);国家自然科学基金应急管理项目(81641008);遵义医学院2017年度学术新苗培养及创新探索专项(CK-1130-004)

摘　　要：目的:探讨葡萄糖-6-磷酸脱氢酶(G6PD)活性在急性白血病患儿中的变化及其与临床特征的相关性。方法:应用1967年WHO推荐的Zinkham法检测74例AL(ALL 50例,AML 24例)患儿外周血中G6PD活性,分析其活性与临床特征的相关性。以70例正常健康体检儿童外周血中G6PD活性作为对照。结果:ALL和AML组的G6PD活性均明显低于正常对照组(P=0. 000,P=0. 000),ALL组与AML之间G6PD活性无统计学差异; AL患儿细菌感染组、真菌感染组、无感染组(无细菌和真菌感染),分别与对照组比较差异均有统计学意义(P=0. 02,P=0. 001,P=0. 001),真菌感染组再分别与细菌感染组和无感染组比较差异有统计学意义(P=0. 004,P=0. 019); AL患儿的G6PD活性与白细胞数及中性粒细胞百分比呈线性相关(P=0. 000,P=0. 001,r=0. 465,r=0. 434); G6PD活性缺乏组中位生存时间高于G6PD活性正常组,但差异无统计学意义(P=0. 4149)。结论:急性白血病患儿G6PD活性明显低于正常健康儿童,与患儿白细胞数和中性粒细胞百分比呈线性相关,G6PD活性降低易罹患真菌感染,且感染更严重。Objective: To explore the change of G6PD activity in children with acute leukemia ( AL ) and its correlation with the clinical characteristics.Methods: The G6PD activity in peripheral blood samples from 74 children disagnosed as AL ( 50 cases of ALL,and 24 cases of AML) was detected by Zinkham method recommended by WHO in 1967,and its relevance with clinical indicators was statistically analyzed.The peripheral blood samples of 70 healthy children were used as the controls.Results: The G6PD activity in ALL and AML groups was significantly lower than that in the control group ( P = 0.000,P = 0.000) and there was no statistical difference between ALL and AML groups.The G6PD activity in bacterial,fungal infection and non - infection groups ( no bacterial and fungal infection) were statistically different from control group ( P = 0.02,P = 0.001,P = 0.001 ) ,respectively.The G6PD activity in bacterial infection group and non - infection group was statistically different from with fungal infection group ( P = 0.004,P = 0.019) ,respectively.The G6PD activity linearly correlated with leukocyte count and neutrophil percentage in AL children ( P = 0.000,P = 0.001,r = 0.465,r = 0.434) ,respectively.The median survival time of G6PD activity deficiency group was higher than that in the normal group,but without statistically significant difference ( P = 0.4149) .Conclusion: The G6PD activity in AL children is significantly lower than that in healthy children,and the G6PD activity linearly relates with leukocyte count and neutrophil percentage of AL children.The patients with G6PD activity deficiency is more susceptible to fungal infection,moreover the infection is more serious.

关 键 词：急性白血病 葡萄糖-6-磷酸脱氢酶活性 真菌感染 

分 类 号：R733.71[医药卫生—肿瘤]