血清免疫球蛋白检测在急性白血病患者中的临床意义  

Clinical significance of serum immunoglobulin detection in patients with acute leukemia

作　　者：施青青[1] 孙幸[1] 吴蔚[1] 倪军[1] 方悦之[1] 朱淼[1] 孙梅[1] 顾健[1] SHI Qingqing;SUN Xing;WU Wei;NI Jun;FANG Yuezhi;ZHU Miao;SUN Mei;GU Jian(Laboratory Room of Hematonosis,Northern Jiangsu People′s Hospital/Yangzhou Municipal Institute of Hematology,Yangzhou,Jiangsu 225001,China)

机构地区：[1]江苏省苏北人民医院血液病实验室/扬州市血液学研究所,江苏扬州225001

出　　处：《检验医学与临床》2020年第20期2975-2977,2981,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血清免疫球蛋白(Ig)在急性白血病(AL)患者中的水平及与临床特征和感染指标的关系。方法收集2016—2018年在该院初诊的AL患者123例,所有患者按照初诊时的疾病类型分为急性早幼粒细胞白血病(APL)组20例、急性非淋巴细胞白血病(ANLL)组(除APL外)66例、急性淋巴细胞白血病(ALL)组37例,对照组为同期50例健康体检者。采用酶联免疫吸附试验检测各组血清IgG、IgA、IgM、kappa轻链(κ)、Lambda轻链(λ)水平,分析其表达与患者临床特征[性别、年龄、外周血白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)]以及感染指标[C反应蛋白(CRP)和降钙素原(PCT)]的关系。结果ANLL组患者IgG、IgA、λ水平显著高于对照组(P<0.05)。ALL组IgG水平显著高于对照组(P<0.05)。当外周血WBC>10×109/L或PLT>300×109/L时,各项Ig水平均高于WBC、PLT在其他范围时的Ig水平。当PCT≥0.5 ng/mL或CRP≥10.0 ng/L时,IgG水平显著升高(P<0.05)。发生感染患者的各项Ig水平均高于未感染患者(P<0.05)。结论AL患者血清Ig水平与外周血WBC和PLT以及感染指标存在一定相关性,可为初诊AL患者的临床诊断和感染评估提供依据。Objective To explore the levels of serum immunoglobulins in the patients with acute leukemia(AL)and their relationship with the clinical features and infection indicators.Methods A total of 123 patients with newly diagnosed AL in this hospital during 2016-2018 were collected and divided into the acute promyelocytic leukemia(APL)group(20 cases),acute nonlymphocytic leukemia(ANLL)group(except APL,66 cases)and acute lymphocyte leukemia(ALL)group(37 cases).Contemporaneous 50 subjects undergoing the healthy physical examination served as the control group.The levels of serum IgG,IgA,IgM,kappa(κ)light chain and Lambda(λ)light chain in each group were determined by ELISA.The relationship between the expression levels of serum immunoglobulins and patient′s clinical characteristics such as gender,age,count of peripheral blood white blood cells(WBC),hemoglobin(Hb),platelets count(PLT),and the infection indexes of C reactive protein(CRP)and procalcitonin(PCT)were analyzed.Results The levels of IgG,IgA andλin the ANLL group were significantly higher than those in the control group(P<0.05).The IgG level in the ALL group was significantly higher than that in the control group(P<0.05).When the peripheral blood WBC>10×109/L or PLT>300×109/L,the average level of each Ig was higher than that when WBC and PLT were in the other ranges;when PCT≥0.5 ng/mL or CRP≥10.0 ng/L,the level of IgG were significantly increased(P<0.05).In the patients with infection occurrence,the levels of various Ig were higher than those in the patients with non-infecton(P<0.05).Conclusion The serum Ig level in the patients with AL has a certain relationship with peripheral blood WBC and PLT and the infection indexes in the patients,which can provide a basis for clinical diagnosis and infection assessment for the patients with newly diagnosed AL.

关 键 词：急性白血病 免疫球蛋白 感染 C反应蛋白 降钙素原 

分 类 号：R446.11[医药卫生—诊断学]