CAJ | 학술논문

目的：通过检测氧化应激的相关指标来探讨氧化应激参与急性单核细胞白血病(M5)发病及复发的机制。方法检测原发、复发、化疗缓解后 M5患者细胞内活性氧的水平、外周血血浆中抗氧化酶活性、氧化损伤产物含量,并用透射电镜观察其外周血单个核细胞线粒体的超微结构。结果与正常对照组比较,原发组及复发组 M5患者细胞内活性氧的平均荧光强度均显著增高(P <0.05)；原发组 M5患者血浆中抗氧化酶 T-AOC、SOD 活性降低,氧化损伤产物 LDH、MDA、8-OHdG 含量升高,复发组 T-AOC、SOD 活性显著下降,LDH、MDA、8-OHdG 含量显著升高(P <0.05),而化疗缓解组 T-AOC、SOD 活性升高,LDH、MDA、8-OHdG 含量降低；原发组 M5患者线粒体轻度肿胀、嵴间隙增宽；复发组 M5患者线粒体肿胀、畸形明显。结论氧化应激是 M5发病的始动因素。线粒体是生物氧化进行的主要场所,活性氧及其相关的抗氧化酶之间动态平衡的破坏可能是促进复发的主要原因。
목적：통과검측양화응격적상관지표래탐토양화응격삼여급성단핵세포백혈병(M5)발병급복발적궤제。방법검측원발、복발、화료완해후 M5환자세포내활성양적수평、외주혈혈장중항양화매활성、양화손상산물함량,병용투사전경관찰기외주혈단개핵세포선립체적초미결구。결과여정상대조조비교,원발조급복발조 M5환자세포내활성양적평균형광강도균현저증고(P <0.05)；원발조 M5환자혈장중항양화매 T-AOC、SOD 활성강저,양화손상산물 LDH、MDA、8-OHdG 함량승고,복발조 T-AOC、SOD 활성현저하강,LDH、MDA、8-OHdG 함량현저승고(P <0.05),이화료완해조 T-AOC、SOD 활성승고,LDH、MDA、8-OHdG 함량강저；원발조 M5환자선립체경도종창、척간극증관；복발조 M5환자선립체종창、기형명현。결론양화응격시 M5발병적시동인소。선립체시생물양화진행적주요장소,활성양급기상관적항양화매지간동태평형적파배가능시촉진복발적주요원인。
Objective To study the mechanism of oxidative stress involved in the pathogenesis and relapse of acute monocytic leukemia (M5 ).Methods We detected reactive oxide species (ROS)levels,conducted plasma analysis obtained from 76 M5 patients at diagnosis and at relapse,and observed the ultrastructure of mitochondria of mononuclear cells in peripheral blood by transmission electron microscope.Results Compared with that in the control group,the average fluorescence intensity of intracellular ROS was significantly increased in M5 groups, especially in the relapse patients (P < 0.05 ).Low total antioxidative capacity (T-AOC)and antioxidant enzyme activity were characteristic of M5 at both diagnosis and relapse. However, lactate dehydrogenase (LDH ), malondialdehyde (MDA)and 8-hydroxy-2’-deoxyguanine (8-OHdG)increased significantly at both diagnosis and relapse (P < 0.05 ).Prominent ultrastructural abnormalities (mitochondrial swelling,outer membrane blebs,and aberrant cristae disorder)were present in patients with primary M5,and they were obviously abnormal in relapsing M5 patients.Conclusion Oxidative stress is the initiating factor of M5.Mitochondria are the main intracellular location for ROS generation.To maintain the dynamic balance between ROS and antioxidant defence may be the critical factor for preventing relapse.