急性白血病患儿造血干细胞移植后血清LDH、sIL-2R、GDF15水平变化及其临床意义  

Changes in serum levels of serum lactate dehydrogenase,soluble interleukin-2 receptor,and growth differentiation factor 15 after hematopoietic stem cell transplantation in children with acute leukemia and their clinical significance

作　　者：苏于泰 毛彦娜[1] 马平[1] 刘炜[1] SU Yu-tai;MAO Yan-na;MA Ping;LIU Wei(Department of Hematology and Oncology,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital Zhengzhou Children's Hospital,Zhengzhou 450018,Henan,CHINA)

机构地区：[1]郑州大学附属儿童医院&河南省儿童医院郑州儿童医院血液肿瘤科,河南郑州450018

出　　处：《海南医学》2024年第19期2797-2802,共6页Hainan Medical Journal

基　　金：河南省科技攻关计划项目(编号:212102310036)。

摘　　要：目的检测急性白血病患儿造血干细胞移植后血清乳酸脱氢酶(LDH)、可溶性白细胞介素-2受体(sIL-2R)、生长分化因子15(GDF15)水平,并探讨其临床意义。方法回顾性分析2022年1月至2023年6月河南省儿童医院收治的78例急性白血病患儿的临床诊治资料,所有患儿均进行造血干细胞移植,检测患儿移植前后的血清LDH、sIL-2R、GDF15水平。依据患儿移植后6个月的预后情况分为预后良好组(n=64)和预后不良组(n=14)。比较两组患儿的基线资料及移植前后的血清LDH、sIL-2R、GDF15水平,采用偏相关性系数分析血清LDH、sIL-2R、GDF15水平与移植预后的偏相关性,采用受试者工作特征(ROC)曲线分析血清LDH、sIL-2R、GDF15单独及联合预测移植预后的效能,并比较各预测方案的预测效能。结果移植后,患儿的血清LDH、sIL-2R、GDF15水平分别为(224.83±65.27)U/L、(257.41±80.26)U/mL、(0.87±0.26)ng/mL,明显低于移植前的(418.96±135.22)U/L、(492.83±140.47)U/mL、(1.39±0.45)ng/mL,差异均有统计学意义(P<0.05);预后不良组患儿移植前未达到完全缓解(CR)占比及移植后血清LDH、sIL-2R、GDF15水平分别为64.29%、(327.49±98.42)U/L、(349.83±112.06)U/mL、(1.17±0.32)ng/mL,明显高于预后良好组患儿的26.56%、(202.37±65.87)U/L、(237.19±75.17)U/mL、(0.80±0.26)ng/mL,差异均有统计学意义(P<0.05);偏相关性分析结果显示,在控制移植前未达到CR等因素后,移植后血清LDH(偏相关性系数=0.894,95%CI:1.415~3.029)、sIL-2R(偏相关性系数=0.875,95%CI:1.374~2.982)、GDF15(偏相关性系数=0.902,95%CI:1.692~3.047)水平仍与移植预后不良显著相关(P<0.05);ROC分析结果显示,移植后血清LDH、sIL-2R、GDF15单独预测移植预后的曲线下面积(AUC)分别为0.747、0.787、0.844,LDH+sIL-2R、LDH+GDF15、sIL-2R+GDF15及三者联合预测预后的AUC分别为0.884、0.886、0.898、0.949;成对对比分析结果显示,移植后血清三者联合预测AUC最大(0.949),预测�Objective To detect the levels of serum lactate dehydrogenase(LDH),soluble interleukin-2 receptor(sIL-2R),and growth differentiation factor 15(GDF15)in children with acute leukemia after hematopoietic stem cell transplantation,and to explore their clinical significance.Methods The clinical data of 78 children with acute leukemia admitted to Henan Children's Hospital from January 2022 to June 2023 were retrospectively analyzed.All patients underwent hematopoietic stem cell transplantation,and their serum levels of LDH,sIL-2R,and GDF15 were measured before and after transplantation.Based on the prognosis of children at 6 months after transplantation,they were divided into a good prognosis group(n=64)and an adverse prognosis group(n=14).Baseline data and pre-transplant and post-transplant serum levels of LDH,sIL-2R,and GDF15 were compared between the two groups.The partial correlation coefficient was used to analyze the partial correlation between serum levels of LDH,sIL-2R,and GDF15 and transplant prognosis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of serum levels of LDH,sIL-2R,and GDF15 alone or in combination for predicting transplant prognosis,and the prediction efficacy of each prediction scheme was compared.Results After transplantation,the levels of serum LDH,sIL-2R,and GDF15 in children were(224.83±65.27)U/L,(257.41±80.26)U/mL,and(0.87±0.26)ng/mL,respectively,which were significantly lower than(418.96±135.22)U/L,(492.83±140.47)U/mL,and(1.39±0.45)ng/mL before transplantation(P<0.05).In the poor prognosis group,the proportion of children who did not achieve complete remission(CR)before transplantation and the levels of serum LDH,sIL-2R,GDF15 after transplantation were 64.29%,(327.49±98.42)U/L,(349.83±112.06)U/mL,and(1.17±0.32)ng/mL in the poor prognosis group,respectively,which were significantly higher than 26.56%,(202.37±65.87)U/L,(237.19±75.17)U/mL,and(0.80±0.26)ng/mL in the good prognosis group(P<0.05).The results of partial correlation analysi

关 键 词：急性白血病 造血干细胞移植 乳酸脱氢酶 可溶性白细胞介素-2受体 生长分化因子15 预后 预测 

分 类 号：R729[医药卫生—儿科]