血清乳酸脱氢酶在评估急性溶血性贫血治疗疗效中的价值
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摘要
目的了解血清乳酸脱氢酶(LDH)在急性溶血性贫血治疗疗效评估中的价值。方法选取47例急性溶血性贫血患者,检测所有患者治疗前的血清LDH水平,然后开始糖皮质激素治疗,治疗6周后,对所有患者进行血清LDH检测,并根据疗效将患者分为完全缓解组、部分缓解组及无效组,比较3组患者治疗前后的血清LDH变化。结果治疗6周后,完全缓解22例,部分缓解18例,无效7例,临床缓解率为85.1%,完全缓解组和部分缓解组患者的血清LDH水平均比治疗前明显下降(P<0.01),无效组的血清LDH水平则无明显变化。治疗前后血清LDH的下降幅度以完全缓解组为最大,其次为部分缓解组、无效组,组间两两比较差异有统计学意义(P<0.01)。结论血清LDH水平下降幅度越大,急性溶血性贫血的疗效越好,血清LDH水平检测可作为急性溶血性贫血的治疗疗效评价指标,动态观察有助于判断溶血性疾病进展情况。
Objective To analyze the value of serum lactate dehydrogenase(LDH) in assessing the therapeutic efficacy in acute hemolytic anemia. Methods For the 47 patients with acute hemolytic anemia admitted and treated, detect their serum LDH level before the treatment, then start glucocorticoid treatment, after six weeks of treatment, detect serum LDH, and divide them into Complete Remission Group, Partial Remission Group and Ineffectiveness Group according to therapeutic efficacy. The three groups were compared in terms of the change in serum LDH before and after treatment. Results After six-week treatment, there were 22 cases of complete remission, 18 cases of partial remission and 7 cases of ineffectiveness. Clinical remission rate was 85.1%. The serum LDH level of Complete Remission Group and Partial Remission Group significantly decreased compared with that before the treatment(P<0.01) while the LDH level of Ineffectiveness Group had no significant change compared with that before the treatment(P>0.05). As for the decrease amplitude of serum LDH before and after treatment, Complete Remission Group was the greatest, followed by Partial Remission Group and Ineffectiveness Group, and there was statistical difference between the groups(P<0.01). Conclusion The greater the decrease amplitude, the better therapeutic efficacy the acute hemolytic anemia. The detection of serum LDH level can be the evaluation indicator of therapeutic efficacy. Dynamic observation is helpful in judging the progress of hemolytic diseases.
Objective To analyze the value of serum lactate dehydrogenase(LDH) in assessing the therapeutic efficacy in acute hemolytic anemia. Methods For the 47 patients with acute hemolytic anemia admitted and treated, detect their serum LDH level before the treatment, then start glucocorticoid treatment, after six weeks of treatment, detect serum LDH, and divide them into Complete Remission Group, Partial Remission Group and Ineffectiveness Group according to therapeutic efficacy. The three groups were compared in terms of the change in serum LDH before and after treatment. Results After six-week treatment, there were 22 cases of complete remission, 18 cases of partial remission and 7 cases of ineffectiveness. Clinical remission rate was 85.1%. The serum LDH level of Complete Remission Group and Partial Remission Group significantly decreased compared with that before the treatment(P<0.01) while the LDH level of Ineffectiveness Group had no significant change compared with that before the treatment(P>0.05). As for the decrease amplitude of serum LDH before and after treatment, Complete Remission Group was the greatest, followed by Partial Remission Group and Ineffectiveness Group, and there was statistical difference between the groups(P<0.01). Conclusion The greater the decrease amplitude, the better therapeutic efficacy the acute hemolytic anemia. The detection of serum LDH level can be the evaluation indicator of therapeutic efficacy. Dynamic observation is helpful in judging the progress of hemolytic diseases.
引文
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[2]林辉,郑淑华,陈一农.药源性溶血性贫血文献报道123例综合分析[J].中国临床药学杂志,2003,12(1):38-39.
[3]时昊,张日.溶血性贫血患者血清乳酸脱氢酶活性临床检测研究[J].中国医师杂志,2003,5(7):961-962.
[4]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:68-71.
[5]刘清池,李建英,马亚辉,等.雷帕霉素治疗28例复发性自身免疫性溶血性贫血患者疗效观察[J].中华血液学杂志,2012,33(3):241-242.
[6]陆益龙,徐生祥,巴荣.急性白血病患者血清LDH及IL-12检测的临床意义[J].临床检验杂志,2005,23(1):50-51.
[7]方文,刘仁贵.溶血对血浆酶活性测定的影响[J].贵阳医学院学报,2005,30(5):431-432.
[8]刘冯,肖丁华,莫东华,等.血清乳酸脱氢酶在儿童急性溶血性贫血诊治中的临床意义[J].中国全科医学杂志,2011,14(2):538-539.
[9]金皎.自身免疫性溶血性贫血研究进展[J].实用儿科临床杂志,2010,25(15):1127-1128.
[10]徐世荣.温抗体型自身免疫性溶血性贫血诊治进展[J].河北医药,2004,26(3):213-215.
[11]刘冯.溶血危象临床特点的相关分析及LDH、s Tf R在急性溶血性贫血意义的探讨[D].广州:暨南大学,2006:29-30.