目的:观察血清维生素B12(VitB12)的水平与急性白血病不同类型、不同疾病阶段的关联。方法:收集140例确诊为急性白血病的患者,其中急性髓系白血病(acute myeloid leukemia,AML)95例、急性杂合型白血病(hybrid acute leukemia,HAL)2例、急性淋巴细胞性白血病(acute lymphoblastic leukemia,ALL)43例,分成3组:初治组63例、第1次完全缓解(complete response,CR)组(CR1组)57例以及复发组20例。应用化学发光法检测3组患者血清VitB12的水平。结果:初治组中,血清VitB12水平的升高主要见于AML患者,尤其是M3患者。AML初治患者中血清VitB12水平升高者显著多于CR1的AML患者(P<0.01);AML复发患者中血清VitB12水平升高者也显著多于CR1组的AML患者(P<0.01)。ALL初治患者与CR1患者相比,血清VitB12水平的差异无统计学意义(P>0.05);但ALL复发患者的血清VitB12水平升高者显著多于CR1的ALL患者(P<0.01)。结论:VitB12是急性白血病的诊断指标之一,在急性白血病患者中存在血清VitB12水平的动态变化,血清VitB12水平的升高与疾病活动程度相关。 Objective: To observe the relationship between serum vitamin B12 (VitB12) levels and different types and stages of acute leukemia. Methods: One hundred and forty patients diagnosed as acute leukemia were collected, including 95 cases of acute myeloid leukemia (AML), 2 cases of acute leukemia (HAL), acute lymphoblastic leukemia ALL patients were divided into three groups: 63 in the newly diagnosed group, 57 in the first complete CR (CR1) group and 20 in the recurrent group. The levels of serum VitB12 in three groups were detected by chemiluminescence. Results: In the untreated group, elevated serum levels of VitB12 were mainly found in AML patients, especially M3 patients. The serum levels of VitB12 in patients with AML were significantly higher than those in CR1 patients with AML (P <0.01). The serum levels of VitB12 in patients with AML recurrence were also significantly higher than those in CR1 patients with AML (P <0.01). There was no significant difference in serum VitB12 levels between patients with ALL and those with CR1 (P> 0.05). However, the serum levels of VitB12 in patients with ALL relapse were significantly higher than those with CR1 (P <0.01). Conclusion: VitB12 is one of the diagnostic criteria of acute leukemia. There is a dynamic change of serum VitB12 level in patients with acute leukemia. The level of serum VitB12 is correlated with the degree of disease activity.