血液肿瘤患者中血管性血友病因子、D二聚体、抗凝血酶检测的意义

Significance of the Changes of Plasma vWF,D-dimer and Antithrombin Levels in Patients with Hematological Malignancy

目的探讨血液系统肿瘤患者血浆中血管性血友病因子(vWF)、D二聚体(D-D)、抗凝血酶(AT)水平变化及临床意义。方法以42例急慢性白血病、淋巴瘤、多发性骨髓瘤患者为观察对象,分初发组、缓解组、未缓解组、复发组,26例健康体检者为正常对照,测定血浆中vWF、D-D、AT水平。结果(1)初发血液肿瘤患者血浆中vWF、D-D水平明显高于正常对照组(P值均＜0．01)；缓解组vWF、D-D明显低于初发、对照组；复发患者vWF再次明显升高,与正常组和初发组比较差异有显著性(P＜0．01)；未缓解组vWF、D-D高于对照组和缓解组。(2)恶性肿瘤各组AT水平与对照组无明显差异(P＞0．05),但在疾病晚期AT明显降低(P＜0．01)。结论血液肿瘤患者存在不同程度的高凝状态,血浆vWF、D-D含量变化对病情和预后的评估有一定的参考价值,血浆AT水平降低是反映病情危重的指标。

Objective To investigate the clinical significance of the changes of plasma von Willebrand factor （vWF）, D-dimer （D-D） and antithrombin （AT） levels in patients with hematological malignancy. Methods The levels of plasma vWF , D-D and AT in 42 patients including leukemia ,lymphoma and multihigher than those in normal controls （ P 〈 0. 05）. Plasma vWF activity and D-D levels were found to be decreased in the patients in remission. Extremely high levels of vWF were found in relapse patients. No statistically significant difference was found in the AT levels between the untreated patients, the patients in remission, the patients in relapse and the control group. On the other band, plasma antithrombin activity significandy decreased in those malignant patients considered to be in a critical condition （ P 〈 0. 05）. Conclusion The determination of levels of vWF and D-D may be important for the evaluation of the effect of treatment in hematological malignancy. The decrease of AT activity probably reflect a bad prognosis and the severity of disease.