Correlation Analysis Between LDH And Paroxysmal Nocturnal Hemoglobinuria

Objective: This study retrospectively analyzed the clinical features of 77 patients with paroxysmal nocturnal hemoglobin(PNH)to explore their association with serum lactate dehydrogenase level.Methods: The basic information and clinical data of 77 patients with PNH were collected.And then the 77 subjects with PNH were divided into two groups for patients with lactate dehydrogenase/normal upper limit(LDH/ULN)?1.5 as group A and patients with LDH/ULN<1.5 as group B.SPSS22.0 statistical software was used to analyze and process the data.The enumeration data were expressed as the number of cases and the percentage(%),and ?2 test was used to compare the data between the two groups.Measurement data were expressed as mean ± standard deviation,and t-test was used to compare the mean between the two groups.The test level was a=0.05,and the difference was statistically significant at P<0.05.Results: In this study,there was no difference in the distribution of male-female and age in each group.Patients in group B had significantly more history of bone marrow hematopoietic failure(BMF)than patients in group A.The symptoms of abdominal pain,dysphagia,dyspnea and hemoglobinuria in group A were significant than group B,the difference was statistically significant(P<0.05).But there was no significant difference in fatigue symptoms between group A and group B(P=0.852).There was also no significant difference in the incidence of TE events between group A and group B(P=0.836),but the LDH/ULN of the patients with thromboembolic events was significantly higher than that of the patients without thromboembolic events.Compared with group B,Hemoglobin Hb,leukocyte WBC,platelet PLT,reticulocyte absolute value Ret,LDH/ULN,granulocyte clone ratio and erythrocyte clone ratio were all significantly higher in group A.Conclusions: The incidence of PNH in males was more than that in females,and the majority of them were young adults.The level of LDH in PNH patients was significantly higher than normal,and the increase level was more obvious when hemoglobinuria occurred.So the degree of hemolysis can be evaluated by detecting the LDH level.When LDH/ULN?1.5,patients with PNH were more likely to complicate with abdominal pain,difficulty swallowing and difficulty breathing,which should be pay attention to the aggravation of hemolysis.Nearly half of PNH patients had a history of BMF,and the number of BMF patients in group A were significantly less than that in group B.The pathogenesis of PNH might be related to the destruction of the hematopoietic microenvironment in the bone marrow.PNH screening should be performed in patients with unexplained panhematopenia,aplastic anemia and dysplasia syndrome.The LDH level of patients with thromboembolic events was significantly higher than that of patients without thromboembolism.Therefore,the higher the LDH,the greater the possibility of thromboembolism.It was suggested that the patients with significantly higher LDH level should be closely detected for thromboembolism.The incidence of venous thromboembolism in patients with PNH was higher than that in arterial thromboembolism,and the incidence of Budd-Chiari syndrome was the highest,and there was no significant correlation between thromboembolism and age.PNH screening should be performed in patients with rare sites of thromboembolism,especially those with elevated LDH or anemia and hemoglobinuria.