摘要
目的 探究儿童慢性粒细胞白血病(CML)慢性期红细胞参数及血清碱性成纤维细胞生长因子(bFGF)、转化生长因子β1(TGF-β1)及血管内皮生长因子(VEGF)表达变化.方法 前瞻性选取2020年1月至2023年1月在首都医科大学附属北京儿童医院进行治疗的54例CML慢性期患儿为研究组,另随机抽取46名同期在本院进行体检的健康儿童为健康对照组.研究组给予酪氨酸激酶抑制剂治疗.比较两组间红细胞参数及血清bFGF、TGF-β1、VEGF表达变化,并比较研究组治疗前后红细胞参数及血清bFGF、TGF-β1、VEGF表达水平.结果 研究组的RBC、血红蛋白、红细胞压积(HCT)及平均红细胞血红蛋白浓度(MCHC)水平分别为(3.45±0.04)× 1012/L、(102.33±1.15)g/L、(32.03±0.61)％、322.15±2.58,均显著低于对照组[(4.98±0.03)× 1012/L、(149.78±1.88)g/L、(44.33±0.31)％、334.12±0.77],平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)及红细胞体积分布宽度(RDW)水平分别为(91.44±0.77)fL、(33.15±2.55)pg、(17.55±0.12)％,均显著高于对照组[(89.88±0.34)fL、(30.24±0.16)pg、(12.66±0.11)％],差异均有统计学意义(P＜0.05).研究组的血清bFGF、VEGF水平分别为(30.66±9.66)、(128.68±30.58)pg/mL,均显著高于对照组[(5.26±1.54)、(70.66±11.26)pg/mL],TGF-β1 水平为(38.22±8.06)µg/L,显著低于对照组[(78.66±8.13)μg/L],差异均有统计学意义(P＜0.05).治疗后,研究组患儿的RBC、血红蛋白、HCT、MCV及MCH水平均较治疗前显著降低,MCHC及RDW水平均较治疗前显著升高,差异均有统计学意义(P＜0.05).研究组治疗后的血清bFGF、VEGF水平均较治疗前显著降低,TGF-β1水平较治疗前显著升高,差异均有统计学意义(P＜0.05).结论 在儿童CML慢性期患儿中可见血细胞参数明显异常,血清bFGF、VEGF水平显著升高,TGF-β1水平显著降低.酪氨酸激酶抑制剂治疗CML慢性期能有效改善患儿红细胞形态及功能,抑制肿瘤细胞生长,临床疗效显著,值得临床推广使用.
Abstract
Objective To investigate the changes in red blood cell parameters and serum levels of basic fibroblast growth factor(bFGF),transforming growth factor β1(TGF-β1),and vascular endothelial growth factor(VEGF)in children with chronic myeloid leukemia(CML)chronic phase.Methods A total of 54 children with chronic phase CML who were treated at Beijing Childrens Hospital,Capital Medical Univer-sity from January 2020 to January 2023 were prospectively included in the study group.Additionally,46 healthy children who underwent medical examinations at our hospital during the same period were selected as the healthy control group.The study group was treated with a tyrosine kinase inhibitor,and changes in red blood cell parameters and serum bFGF,TGF-β1,and VEGF expression were compared between the two groups.The red blood cell parameters and serum bFGF,TGF,and VEGF expression levels before and after treatment in the study group were compared.Results The levels of red blood cell(RBC),hemoglobin,hematocrit(HCT),and mean corpuscular hemoglobin concentration(MCHC)in the study group were(3.45±0.04)×1012/L,(102.33±1.15)g/L,(32.03±0.61)％,322.15±2.58,respectively,which were significantly lower than those in the control group[(4.98±0.03)× 1012/L,(149.78±1.88)g/L,(44.33±0.31)％,334.12±0.77],while the levels of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),and red cell distribution width(RDW)were(91.44±0.77)fL,(33.15±2.55)pg,(17.55±0.12)％,respectively,which were significantly higher than those in the control group[(89.88±0.34)fL,(30.24 ±0.16)pg,(12.66±0.11)％],the differences were statistically significant(P＜0.05).The levels of serum bFGF and VEGF in the study group were(30.66±9.66),(128.68±30.58)pg/mL,respectively,which were significantly higher than those in the control group[(5.26± 1.54),(70.66±11.26)pg/mL],while the level of TGF-β1 was(38.22±8.06)μg/L,which was significantly lower than that in the control group[(78.66±8.13)μg/L],the differences were statistically significant(P＜0.05).After treatment,the levels of RBC,hemoglobin,HCT,MCV,and MCH in the study group were significantly lower than those before treatment,while the levels of MCHC and RDW were signifi-cantly higher than those before treatment,the differences were statistically significant(P＜0.05).The levels of serum bFGF and VEGF in the study group after treatment were significantly lower than those before treatment,while the level of TGF-β1 was significantly higher than that before treatment,the differences were statistically significant(P＜0.05).Conclusion The results suggest that children with CML chronic phase ex-hibit significant abnormalities in blood cell parameters,as well as significantly increased serum bFGF and VEGF levels and significantly decreased TGF-β1 levels.Tyrosine kinase inhibitors can effectively improve the morphology and function of red blood cells in children with CML chronic phase,inhibit tumor cell growth,and have significant clinical efficacy,which is worthy of clinical promotion and use.
维普
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