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白血病中的血小板酶异常。

Platelet enzyme abnormalities in leukemias.

作者信息

Sharma S, Purohit Ahl, Pati H P, Kochupillai V

机构信息

Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Indian J Cancer. 2011 Jul-Sep;48(3):323-7. doi: 10.4103/0019-509X.84943.

Abstract

AIM OF THE STUDY

The aim of this study was to evaluate platelet enzyme activity in cases of leukemia.

MATERIALS AND METHODS

Platelet enzymes glucose-6-phosphate dehydrogenase (G6PD), pyruvate kinase (PK) and hexokinase (HK) were studied in 47 patients of acute and chronic leukemia patients, 16 patients with acute myeloid leukemia (AML)(13 relapse, three in remission), 12 patients with acute lymphocytic leukemia (ALL) (five in relapse, seven in remission), 19 patients with chronic myeloid leukemia (CML).

RESULTS

The platelet G6PD activity was significantly low in cases of AML, ALL and also in CML. G6PD activity was normalized during AML remission. G6PD activity, although persistently low during ALL remission, increased significantly to near-normal during remission (P < 0.05) as compared with relapse (P < 0.01). Platelet PK activity was high during AML relapse (P < 0.05), which was normalized during remission. Platelet HK however was found to be decreased during all remission (P < 0.05). There was a significant positive correlation between G6PD and PK in cases of AML (P < 0.001) but not in ALL and CML. G6PD activity did not correlate with HK activity in any of the leukemic groups. A significant positive correlation was however seen between PK and HK activity in cases of ALL remission (P < 0.01) and CML (P < 0.05).

CONCLUSIONS

Both red cell and platelet enzymes were studied in 36 leukemic patients and there was no statistically significant correlation between red cell and platelet enzymes. Platelet enzyme defect in leukemias suggests the inherent abnormality in megakaryopoiesis and would explain the functional platelet defects in leukemias.

摘要

研究目的

本研究旨在评估白血病患者的血小板酶活性。

材料与方法

对47例急慢性白血病患者的血小板酶葡萄糖-6-磷酸脱氢酶(G6PD)、丙酮酸激酶(PK)和己糖激酶(HK)进行了研究,其中包括16例急性髓系白血病(AML)患者(13例复发,3例缓解)、12例急性淋巴细胞白血病(ALL)患者(5例复发,7例缓解)、19例慢性髓系白血病(CML)患者。

结果

AML、ALL以及CML患者的血小板G6PD活性均显著降低。AML缓解期G6PD活性恢复正常。ALL缓解期G6PD活性虽持续较低,但与复发期相比,缓解期显著升高至接近正常水平(P<0.05)(与复发期相比,P<0.01)。AML复发期血小板PK活性较高(P<0.05),缓解期恢复正常。然而,发现所有缓解期患者的血小板HK均降低(P<0.05)。AML患者中G6PD与PK之间存在显著正相关(P<0.001),但ALL和CML患者中不存在。在任何白血病组中,G6PD活性与HK活性均无相关性。然而,ALL缓解期(P<0.01)和CML(P<0.05)患者的PK与HK活性之间存在显著正相关。

结论

对36例白血病患者的红细胞和血小板酶进行了研究,红细胞和血小板酶之间无统计学显著相关性。白血病中的血小板酶缺陷提示巨核细胞生成存在内在异常,这可以解释白血病中血小板的功能缺陷。

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