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目的探讨肝炎肝硬化骨髓祖细胞变化对血清乳酸脱氢酶(LDH)的影响及其临床意义。方法随机选择代偿期及失代偿期肝炎肝硬化各13例,共26例患者,其中男性21例,女性5例;年龄26~58岁,平均年龄46岁。对照组10例,其中男性8例,女性2例;年龄31~52岁,平均年龄39岁。进行骨髓晚期红系祖细胞(CFU-E)、粒-单系祖细胞(CFU-GM)及成纤维祖细胞(CFU-F)体外培养,血清丙氨酸转氨酶(ALT)及LDH检测。结果代偿期及失代偿期肝炎肝硬化CFU-E、CFU-GM及CFU-F集落生长率两组比较[(33.21±24.85)×104、(49.38±26.21)×105、(30.98±15.44)×105 vs(9.74±6.85)×104、(31.42±11.78)×105、(21.06±10.47)×105],差异有统计学意义(P<0.05)。三系祖细胞减少组ALT水平明显高于正常组(P<0.01);而LDH水平比较,差异无统计学意义(P>0.05)。Hb降低组LDH水平明显高于Hb正常组,差异有统计学意义(P<0.05);中性粒细胞降低组LDH水平明显高于正常组,差异有统计学意义(P<0.05)。结论检测LDH活性对判断肝炎肝硬化骨髓祖细胞生长程度及监测其预后是一个很有价值的指标。
Objective To investigate the effect of hepatitis B cirrhotic myeloid progenitor cells on serum lactate dehydrogenase (LDH) and its clinical significance. Methods Thirteen patients with decompensated and decompensated cirrhosis were randomly selected. A total of 26 patients, including 21 males and 5 females, were aged 26 to 58 years with a mean age of 46 years. The control group of 10 patients, including 8 males and 2 females; aged 31 to 52 years, mean age 39 years. CFU-E, CFU-GM and CFU-F were cultured in vitro, serum alanine aminotransferase (ALT) and LDH were detected. Results The growth rates of CFU-E, CFU-GM and CFU-F in cirrhotic patients with decompensated and decompensated hepatitis [(33.21 ± 24.85) × 104, (49.38 ± 26.21) × 105, (30.98 ± 15.44 ) × 105 vs (9.74 ± 6.85) × 104, (31.42 ± 11.78) × 105, (21.06 ± 10.47) × 105, respectively), the difference was statistically significant (P <0.05). The level of ALT in the three progenitor cell reduction group was significantly higher than that in the normal group (P <0.01). There was no significant difference in LDH level between the two groups (P> 0.05). Hb decreased LDH levels were significantly higher than the Hb normal group, the difference was statistically significant (P <0.05); neutropenia LDH levels were significantly higher than the normal group, the difference was statistically significant (P <0.05). Conclusion The detection of LDH activity is a valuable index for judging the growth of hepatitis B cirrhotic myeloid progenitor cells and monitoring its prognosis.