CAJ | 학술논문

应用ELISA法检测了60例急性白血病（AL）患者及36例正常对照者的血清可溶性肿瘤坏死因子受体（sTNFR-Ⅰ和sTNFR-Ⅱ）及血清肿瘤坏死因子α（TNFα）。结果显示，①初发未治组及复发难治组血清sTNFR-Ⅰ和sTNFR-Ⅱ浓度均明显高于正常对照组（P＜0.01）；骨髓缓解组血清sTNFR浓度与正常对照组无明显差异。AL患者与对照组比较血清TNF-α水平明显增高（P＜0.001）；②血清TNF-α水平与sTNFR-Ⅰ呈显著性正相关（r＝0.684，P＜0.01），与sTNFR-Ⅱ无相关性（r＝0.310，P＞0.05）；血清sTNFR-Ⅰ、sTNFR-Ⅱ水平与外周血幼稚细胞数呈显著正相关（r＝0.748，P＜0.001；r＝0.384，P＜0.05）；③30例初发未治者治疗前血清sTNFR-Ⅰ＜0.89μg／L、sTNFR-Ⅱ＜1.43μg／L者的BMR率（70.0％、61.5％）明显高于sTNFR-Ⅰ≥0.89μg／L、sTNFR-Ⅱ≥1.43μg／L者的BMR率（χ２＝10.80，P＜0.01；χ２＝8.21，P＜0.01）；④采用多因素非条件Logistic回归分析，发现仅血清sTNFR-Ⅰ＜2.0μg／L及外周血WBC＜10×10９／L对骨髓缓解率有显著影响（OR＝0.387，P＝0.0025；OR＝0.5249，P＝0.0087）。因此认为，AL患者血清sTNFR水平与白血病细胞、病程和化疗的反应相关，血清sTNFR水平可作为估计肿瘤负荷及治疗效果的一项可靠指标。
응용ELISA법검측료60례급성백혈병（AL）환자급36례정상대조자적혈청가용성종류배사인자수체（sTNFR-Ⅰ화sTNFR-Ⅱ）급혈청종류배사인자α（TNFα）。결과현시，①초발미치조급복발난치조혈청sTNFR-Ⅰ화sTNFR-Ⅱ농도균명현고우정상대조조（P＜0.01）；골수완해조혈청sTNFR농도여정상대조조무명현차이。AL환자여대조조비교혈청TNF-α수평명현증고（P＜0.001）；②혈청TNF-α수평여sTNFR-Ⅰ정현저성정상관（r＝0.684，P＜0.01），여sTNFR-Ⅱ무상관성（r＝0.310，P＞0.05）；혈청sTNFR-Ⅰ、sTNFR-Ⅱ수평여외주혈유치세포수정현저정상관（r＝0.748，P＜0.001；r＝0.384，P＜0.05）；③30례초발미치자치료전혈청sTNFR-Ⅰ＜0.89μg／L、sTNFR-Ⅱ＜1.43μg／L자적BMR솔（70.0％、61.5％）명현고우sTNFR-Ⅰ≥0.89μg／L、sTNFR-Ⅱ≥1.43μg／L자적BMR솔（χ２＝10.80，P＜0.01；χ２＝8.21，P＜0.01）；④채용다인소비조건Logistic회귀분석，발현부혈청sTNFR-Ⅰ＜2.0μg／L급외주혈WBC＜10×10９／L대골수완해솔유현저영향（OR＝0.387，P＝0.0025；OR＝0.5249，P＝0.0087）。인차인위，AL환자혈청sTNFR수평여백혈병세포、병정화화료적반응상관，혈청sTNFR수평가작위고계종류부하급치료효과적일항가고지표。
Serum tumor necrosis factor（TNFα），serum soluble tumor necrosisfactor receptor Ⅰ（sTNFR-Ⅰ）and soluble tumor necrosis factor receptor（sTNFR-Ⅱ）were detected with enzyme-link immunosorbent assay in 60 acute leukemia（AL） cases and 36 health subjects.The results showed：①Serum levels of sTNFR-Ⅰ and sTNFR-Ⅱ in 30 untrearted AL patients and 14 relapsed／refractory AL patients were significantly higher than those in controls（P＜0.001and P＜0.001），but in 16 bone marrow remission（BMR）AL patients its were not different from those in controls（P＞0.05）.Serum levels of TNFα in AL patients were significantly higher than those in controls（P＜0.001）.②There were remarkably positive relationship between serum TNFα and sTNFR-Ⅰ levels（r＝0.684，P＜0.01），two sTNFRs and peripheral blood blasts（r＝0.748，P＜0.001；r＝0.384，P＜0.05）.③The BMR rate was higher in those serum sTNFR-Ⅰ＜0.89μg／L than that in those sTNFR-Ⅰ≥0.89μg／L（χ２＝10.80，P＜0.01）．④Logistic regression analysis showed that serum sTNFR-Ⅰ＜2.0μg／L and peripheral blood blasts＜10×10９/L were associated with BMR.Those indicated the enhanced serum sTNFRs levels in AL might have relation to leukemic cells，course and drug response and the serum sTNFRs were an index of predicting prognosis.