恶性血液病抗凝血酶活性的变化及其临床意义

Changes of Plasma Antithrombin Levels in Patients with Hematological Malignancy

目的探讨血液肿瘤患者抗凝血酶(AT)活性的变化及其临床意义。方法回顾性分析195例血液肿瘤患者初发、缓解、未缓解、复发时AT活性水平的差异,并具体分析了急、慢性白血病及骨髓增生异常综合征、恶性淋巴瘤、多发性骨髓瘤不同分型或分期患者AT活性水平的变化。结果初发组、缓解组、部分缓解组、复发组较对照组AT活性显著降低(P(0.01);初发、部分缓解及复发组AT活性较缓解组降低,具有显著性差异(P(0.01);非霍奇金淋巴瘤患者各分期之间及骨髓增生异常综合征不同分型之间AT活性无明显差异;多发性骨髓瘤Ⅱ、Ⅲ期患者AT活性较Ⅰ期患者降低(P(0.05);多发性骨髓瘤复发组患者与缓解组比较,AT活性显著降低,β2-微球蛋白、球蛋白及乳酸脱氢酶活性升高,差异均具有显著性(P(0.05);其中AT活性变化与β2-微球蛋白变化具有负相关性(P(0.05)。结论AT活性不仅反映血液病患者抗凝系统的功能,同时可作为判断患者病情变化及其预后的指标之一。对于多发性骨髓瘤患者AT活性水平变化与β2-微球蛋白具有相关性,AT水平变化可能具有预后评估意义。

Objective To assess the clinical value of antithrombin （AT） for hematological malignancy patients. Methods 195 hematological malignancy patients were divided into newly- diagnosed group, complete remission （CR） group, partial remission （PR） group and progression of disease （PD） group. Clinical data of AT were analyzed retrospectivly for these groups and normal control group. Levels of AT, β2- microglobulin （β2-MG） and lactate dehydrogenase （LDH） were analyzed for multiple myeloma patients. Results The plasma AT activity of of newly- diagnosed group, CR, PR and PD group were lower than control group （ P 〈 0.01 ）. Compared with CR group, AT of newly-diagnosed group, PR and PD group were decreased （P 〈 0.01 ）. For multiple myeloma patients, AT of PD, PR group become lower than CR group （P 〈 0.05）, but β2- MG of these groups were higher than CR group （P 〈 0.05 ）. There was negative correlation between AT and β2- MG （P 〈 0.05 ）. Conclusions The determination of levels of AT in patients with hematological malignancy might be important for the evaluation of the effect of treatment and prognosis.