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目的定量检测急性淋巴细胞白血病(急淋)患儿不同阶段外周血中信号连接/结合T细胞受体重排删除环(sjTRECs)水平的变化,以评价其作为预测化疗后严重感染指标的可行性。方法共收集初发急淋患儿(初发组,n=30)、早期强化化疗结束后白细胞恢复且未感染患儿(化疗组,n=36)、化疗后严重感染患儿(感染组,n=30)及正常同龄儿童(正常组,n=50)外周血标本共146份,通过FQ-PCR法检测其sjTRECs水平,并进行组间比较。结果正常组平均sjTRECs为(394±270)copies/103 MNC,高于其他3组(P<0.05);化疗组sjTRECs水平低于初发组[(96±78)copies/103 MNC vs(210±219)copies/103 MNC,P<0.05];感染组sjTRECs水平最低,仅为(48±40)copies/103 MNC。结论监测急淋患儿化疗后sjTRECs水平变化可能有助于早期预测机体严重感染的发生。
Objective To quantitatively detect the changes of the signal transduction / binding T cell receptor rearrangement deletion rings (sjTRECs) in peripheral blood of children with acute lymphoblastic leukemia (acute lymphoblastic leukemia) at different stages to evaluate their feasibility as predictors of severe infection after chemotherapy . Methods A total of 45 children with primary acute lymphocytic leukemia (initial group, n = 30) were enrolled in this study. Patients with recurrent leukopenia and no infection after chemotherapy (n = 36, chemotherapy group) = 30) and 146 normal children (normal group, n = 50). The levels of sjTRECs were detected by FQ-PCR and compared among groups. Results The average sjTRECs in normal group was (394 ± 270) copies / 103 MNC, higher than the other three groups (P <0.05). The sjTRECs levels in chemotherapy group were lower than those in primary group [(96 ± 78) copies / 103 MNC vs 219) copies / 103 MNC, P <0.05]. The lowest level of sjTRECs in infected group was only (48 ± 40) copies / 103 MNC. Conclusion Monitoring the changes of sjTRECs level in the children with acute lymphocytic leukemia after chemotherapy may be helpful to predict the occurrence of severe infection in the early stage.