【摘要】 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B12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B12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B12P<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B12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B12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B12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B12水平的动态变化。血清铁蛋白和维生素B12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。更多还原

【Abstract】 Objective:To observe the dynamic variation of serum ferritin(SF),folic acid,and vitamin B12 levels in patients with acute promyelocytic leukemia(APL) at different disease stages.Methods:Serum SF,folic acid and vitamin B12 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 B12 levels in first diagnosed stage.The number of patients with abnormal variations of SF,folic acid and vitamin B12 level was decreased in CR1 stage compared with those in first diagnosed stage(SF: P<0.05;folic acid and vitamin B12: P<0.01).The serum SF,folic acid and vitamin B12 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 B12 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 B12 levels were in normal ranges in the patients who had 3-year CR.Conclusion:The serum SF,folic acid and vitamin B12 levels had dynamic variation in APL course.Increase in serum SF and vitamin B12 as well as decrease in folic acid are related with the active degree of APL and its tumor load.更多还原