CAJ | 학술논문

目的:观察急性早幼粒细胞白血病(acute promyelocytic leukemia, APL)不同疾病阶段血清铁蛋白、叶酸和维生素B12水平的动态变化.方法:研究对象为36例原发性APL患者,从治疗前至维持完全缓解3年期间,每1～3个月检测这些患者的血清铁蛋白、叶酸和维生素B12的水平.将初诊时、第1次完全缓解时、第1次完全缓解后6个月时、复发时以及第1次完全缓解维持3年时这5个时间点作为统计观察点,动态观察患者的血清铁蛋白、叶酸和维生素B_(12)水平的变化.结果:初诊时,36例APL患者中有27例(75.0%)血清铁蛋白水平升高,28例(77.8%)血清叶酸水平下降,所有36例患者的血清维生素B_(12)水平均升高.第1次完全缓解时,具有上述异常表现的患者人数较初诊时明显减少(血清铁蛋白P＜0.05,血清叶酸P＜0.01,血清维生素B_(12) P＜0.01).随着治疗的进展,患者的血清铁蛋白、叶酸和维生素B12水平逐渐趋于正常.第1次完全缓解后6个月时,大多数患者的血清铁蛋白、叶酸和维生素B_(12)水平均恢复正常.4例患者在维持完全缓解1年后疾病复发,其血清铁蛋白和维生素B_(12)水平均较复发前升高,而血清叶酸水平则较复发前降低,但差异无统计学意义(P＞0.05).15例维持完全缓解3年的患者,其血清铁蛋白、叶酸和维生素B_(12)的水平均正常.结论:APL患者病程中存在血清铁蛋白、叶酸和维生素B_(12)水平的动态变化.血清铁蛋白和维生素B_(12)水平的升高以及血清叶酸水平的降低均与APL的疾病活动状态和肿瘤负荷相关.
목적:관찰급성조유립세포백혈병(acute promyelocytic leukemia, APL)불동질병계단혈청철단백、협산화유생소B12수평적동태변화.방법:연구대상위36례원발성APL환자,종치료전지유지완전완해3년기간,매1～3개월검측저사환자적혈청철단백、협산화유생소B12적수평.장초진시、제1차완전완해시、제1차완전완해후6개월시、복발시이급제1차완전완해유지3년시저5개시간점작위통계관찰점,동태관찰환자적혈청철단백、협산화유생소B_(12)수평적변화.결과:초진시,36례APL환자중유27례(75.0%)혈청철단백수평승고,28례(77.8%)혈청협산수평하강,소유36례환자적혈청유생소B_(12)수평균승고.제1차완전완해시,구유상술이상표현적환자인수교초진시명현감소(혈청철단백P＜0.05,혈청협산P＜0.01,혈청유생소B_(12) P＜0.01).수착치료적진전,환자적혈청철단백、협산화유생소B12수평축점추우정상.제1차완전완해후6개월시,대다수환자적혈청철단백、협산화유생소B_(12)수평균회복정상.4례환자재유지완전완해1년후질병복발,기혈청철단백화유생소B_(12)수평균교복발전승고,이혈청협산수평칙교복발전강저,단차이무통계학의의(P＞0.05).15례유지완전완해3년적환자,기혈청철단백、협산화유생소B_(12)적수평균정상.결론:APL환자병정중존재혈청철단백、협산화유생소B_(12)수평적동태변화.혈청철단백화유생소B_(12)수평적승고이급혈청협산수평적강저균여APL적질병활동상태화종류부하상관.
Objective:To observe the dynamic variation of serum ferritin (SF), folic acid, and vitamin B_(12) levels in patients with acute promyelocytic leukemia (APL) at different disease stages. Methods:Serum SF, folic acid and vitamin B_(12) levels were successively tested in thirty-six patients with primary APL every 1 to 3 months by using chemiluminescence analysis. Five different disease stages were selected as dynamic observation time points: first diagnosed, first complete remission (CR1), six months after CR1, relapsed stage,and CR1 for three years. Results:There were 75.0%(27/36)of patients with abnormal high levels of SF, 77.8% (28/36)of patients with abnormal low levels of folic acid, and 100%(36/36)of patients with increased vitamin B_(12) levels in first diagnosed stage. The number of patients with abnormal variations of SF, folic acid and vitamin B_(12) level was decreased in CR1 stage compared with those in first diagnosed stage (SF: P<0.05;folic acid and vitamin B_(12): P<0.01). The serum SF, folic acid and vitamin B_(12) levels tended to recover step by step with chemotherapy. At six months after CR1 the three parameters of most patients recovered to normal levels. APL was relapsed in 4 patients after 1-year CR. Both SF and vitamin B_(12) levels were increased and the folic acid level was decreased compared with those before replase, but the difference had no significance (P>0.05). The serum SF, folic acid and vitamin B_(12) levels were in normal ranges in the patients who had 3-year CR. Conclusion:The serum SF, folic acid and vitamin B_(12) levels had dynamic variation in APL course. Increase in serum SF and vitamin B_(12) as well as decrease in folic acid are related with the active degree of APL and its tumor load.