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目的:探讨全反式维甲酸(all-trans-retinoic acid,ATRA)治疗急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)过程中血脂含量的变化及可能机制。方法:回顾分析了76例APL患者行ATRA诱导分化治疗过程中血脂水平变化的情况,并同时检测了NB4细胞行ATRA诱导分化过程中培养液上清中血脂水平的变化,以肝癌细胞HepG2和培养液为对照。结果:76例APL患者行ATRA治疗后2周行血清甘油三酯(triglyceride,TG)水平检测,结果显示TG水平较治疗前明显升高(P<0.01),而胆固醇(cholesterol,TC)水平则治疗前后差异无统计学意义。NB4细胞培养72h后培养液上清中TG水平明显升高(P<0.05),NB4细胞在ATRA(0.5μmol/L)作用0、24、48和72h后,培养液上清中TG水平逐渐升高(P<0.01),同样2组细胞培养0,24,48,72h后,培养液上清中TC水平经检测,水平变化差异无统计学意义。HepG2细胞及HepG2细胞在ATRA(0.5μmol/L)培养0、24、48和72h后培养液上清中TG及TC水均无明显变化。结论:ATRA治疗APL过程中可引起高甘油三酯血症,可能与APL细胞代谢有关。
Objective: To investigate the changes of serum lipids in all-trans-retinoic acid (ATRA) treatment of acute promyelocytic leukemia (APL) and its possible mechanism. Methods: A retrospective analysis of 76 cases of APL patients with ATRA induced differentiation during the treatment of lipid levels, and also detect the NB4 cells ATRA-induced differentiation in the culture medium supernatant lipid levels, with HepG2 cells and culture Liquid as a control. Results: Serum triglyceride (TG) levels were detected in 76 patients with APL two weeks after ATRA treatment. The results showed that the level of triglyceride increased significantly (P <0.01) and the level of cholesterol (TC) There was no significant difference between before and after treatment. The level of TG in supernatant of NB4 cells cultured for 72h was significantly increased (P <0.05). After treated with ATRA (0.5μmol / L) for 0,24,48 and 72h, the level of TG in supernatant of NB4 cells gradually increased (P <0.01). After the same two groups of cells were cultured for 0, 24, 48, and 72h, the level of TC in the supernatant of the culture medium was tested. There was no significant difference in the level of TC between the two groups. After ATRA (0.5μmol / L) for 0, 24, 48 and 72h, there were no significant changes in TG and TC in the supernatant of HepG2 cells and HepG2 cells. Conclusion: ATRA can induce hypertriglyceridemia in the treatment of APL, which may be related to the metabolism of APL cells.