急性白血病抗凝纤溶异常的临床意义

Clinical Sgnificance of Abnormal Anticoagulation and Fibrinolysis in Patients with Acute Leukemia

目的观察急性白血病(AL)患者抗凝纤溶指标的变化以探索其在AL诊断、治疗及预后判断中的意义。方法采用STA-R全自动血凝仪对58例急性白血病患者血浆中抗凝血酶(AT)活性、抗纤溶酶(AP)活性及纤溶酶原(PLG)活性定量检测,并将结果与正常对照组进行比较。结果对照组与患者组各期(治疗前、治疗中、复发期)AT、AP、PLG的差异有统计学意义(H=25.509,P<0.05),与缓解期比较差异无统计学意义(P>0.05),出血组高于无出血组,差异有统计学意义(P<0.05),急淋组与急非淋组差异无统计学意义(P>0.05)。结论急性白血病患者存在抗凝纤溶功能异常,抗凝纤溶功能异常是导致AL出血的重要原因,可随病情好转逐渐改善,AT、aP、PLG在指导治疗和判断预后中具有重要价值。

Objective To observe the changes of anticoagulation and fibrinolysis markers in patients with acute leukemia （AL） , and explore its significance in diagnosing, treatment and prognosis. Methods Serum levels of anti-thrombin （AT）, antiplasmin （AP） and plasminogen （PLG） were determined with automated coagulation analyzer STA-R in 58 AL patients and compared with the levels in normal control group. Results The difference of the levels of AT, AP and PLG in AL patients before, during the treatment and in relapse showed statistical significance （ H = 25. 509, P 〈 0.05 ）, compared with the normal control group. However, there is no difference of the markers between the patients in remission stage and the normal control. And the levels of the markers were higher in patients with hemorrhage than in the non-hemorrhage patients （P 〈0.05）. There was no significant differences found between the acute lymphoblastic leukemia group and acute nonlymphocytic leukemia group （ P 〉 0.05 ）. Conclusion These results suggest that the function of anticoagulation and fibrinolysis is abnormal in patients with acute leukemia. It＇ s an important cause of hemorrhage in AL patients and the function would be improved when the patients get better. The levels of AT, AP and PLG are of significant importance for the treating and prognosis in AL.