血清vWF、Treg相关细胞因子在急性白血病患儿危险分层及疗效评估中的价值  

Value of Serum vWF and Treg-Related Cytokines in Risk Stratification and Efficacy Evaluation of Children with Acute Leukemia

作　　者：宋丽丽[1] 李四保[1] 周玉洁[1] 郝腾 臧文涛 李帅全 姚小静 赵雪莲[1] SONG Lili;LI Sibao;ZHOU Yujie;HAO Teng;ZANG Wentao;LI Shuaiquan;YAO Xiaojing;ZHAO Xuelian(Department of Pediatric Hematology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第三附属医院儿童血液科,河南郑州450000

出　　处：《河南医学研究》2024年第17期3176-3180,共5页Henan Medical Research

摘　　要：目的探究血清血管性血友病因子(vWF)、调节性T细胞(Treg)相关细胞因子[转化生长因子-β(TGF-β)、白介素-10(IL-10)、白介素-35(IL-35)]在急性白血病(AL)患儿危险分层及疗效评估中的价值,为AL患儿临床诊疗提供参考。方法选取2020年2月至2022年8月郑州大学第三附属医院收治的78例AL患儿,根据CCLG-ALL-2018方案危险分层分为低危组(39例)、中危组(21例)、高危组(18例)3个亚组,分别比较不同类型、不同危险分层患儿血清vWF、TGF-β、IL-10、IL-35水平,并进行相关性分析。AL患儿均接受规范化治疗,根据治疗1 a疗效评估结果分为临床有效组(完全缓解+部分缓解,62例)、临床无效组(未缓解,16例),分别比较两组治疗2、6个月血清vWF、TGF-β、IL-10、IL-35水平,分析其对AL患儿疗效的预测价值。结果低危组血清vWF、IL-10、IL-35水平低于中危组,中危组血清vWF、IL-10、IL-35水平低于高危组(P<0.05);低危组血清TGF-β水平高于中危组,中危组血清TGF-β水平高于高危组(P<0.05);Spearman相关系数法分析显示,血清vWF、IL-10、IL-35与AL患儿危险分层呈正相关,血清TGF-β与AL患儿危险分层呈负相关(P<0.05);78例AL患儿经1 a治疗后有28例完全缓解、34例部分缓解,计入临床有效组(62例),16例未缓解,计入临床无效组(16例)。治疗2、6个月临床有效组血清vWF、IL-10、IL-35水平均低于临床无效组,血清TGF-β水平高于临床无效组,差异有统计学意义(P<0.05);治疗2、6个月各血清指标联合预测AL患儿临床无效的曲线下面积分别为0.875、0.933(P<0.05)。结论血清vWF、TGF-β、IL-10、IL-35与AL患儿危险分层及疗效有关,动态监测血清vWF、Treg相关细胞因子有利于病情及疗效评估。Objective To explore the value of serum von Willebrandt factor(vWF),regulatory T cell(Treg)related cytokines[transforming growth factor-β(TGF-β),interleukin-10(IL-10),interleukin-35(IL-35)]in risk stratification and efficacy assessment of children with acute leukemia(AL),and provide reference for clinical diagnosis and treatment of AL children.Methods A total of 78 children with AL admitted to the Third Affiliated Hospital of Zhengzhou University from February 2020 to August 2022 were selected and divided into three subgroups according to the risk stratification of the CCLG-ALL-2018 protocol:low-risk group(39 cases),intermediate-risk group(21 cases)and high-risk group(18 cases).The levels of serum vWF,TGF-β,IL-10,and IL-35 in children with different types and different risk stratifications were compared and analyzed.All children with AL received standardized treatment,and were divided into a clinically effective group(complete remission+partial remission,62 cases)and a clinically ineffective group(no remission,16 cases)based on the 1-year efficacy evaluation results.The levels of serum vWF,TGF-β,IL-10,and IL-35 were compared between the two groups at 2 and 6 months of treatment,and their predictive value for the efficacy of treatment in children with AL was analyzed.Results The levels of serum vWF,IL-10 and IL-35 in the low-risk group were lower than those in the medium-risk group,and the levels of serum vWF,IL-10 and IL-35 in the medium-risk group were lower than those in the high-risk group(P<0.05).The level of serum TGF-βin the low-risk group was higher than that in the intermediate-risk group,while the level of serum TGF-βin the intermediate-risk group was higher than that in the high-risk group(P<0.05).Spearman correlation coefficient analysis showed that serum vWF,IL-10,and IL-35 were positively correlated with the risk stratification of AL children,while serum TGF-βwas negatively correlated with the risk stratification of AL children(P<0.05).After 1 year of treatment,28 cases of complete remission a

关 键 词：急性白血病 疗效 血管性血友病因子 调节性T细胞 白介素-10 白介素-35 转化生长因子-β 

分 类 号：R733.71[医药卫生—肿瘤]