急性白血病止、凝血变化的研究

Study on hemostatic and coagulation changes in acute leukemia

目的研究急性白血病（ＡＬ）的止、凝血异常及维甲酸（ＡＴＲＡ）、砷剂（Ａｓ２Ｏ３）治疗对急性早幼粒细胞性白血病（ＡＰＬ）止凝血的影响。方法用凝血、抗凝、纤溶指标观察ＡＬ血浆、细胞裂解液中的相应改变。结果ＡＬ发病时有不同程度的凝血系统活化，内皮细胞损伤，血小板激活，纤溶功能亢进；ＡＰＬ有组织因子（ＴＦ）的异常表达，ＡＴＲＡ、Ａｓ２Ｏ３有下调ＡＰＬＴＦ表达的作用。结论不同类型ＡＬ的止凝血异常并不完全相同，ＡＴＲＡ、Ａｓ２Ｏ３通过下调ＡＰＬＴＦ表达改善了早期的出血症状。

Objective To study the hemostatic and coagulation abnormalities in acute leukemia and acute promyelocytic leukemia by treating with all trans retinoic acid and arsenic trioxide. Methods Coagulation, anti coagulation and fibrinolysis parameters were observed with patient's plasma and cellular lysate. Results There existed activation of coagulant system of varying extent as well as platelet activation, endothelial injury and hyperfibrinolysis; promyelocytic leukemia cells showed abnormally expressed tissue factor and all trans retinoic acid as well as arsenic triooxide downregulated the expression of TF. Conclusion The hemostatic and coagulation abnormalities in various types of acute leukemia are not the same, All trans retinoic acid and arsenic trioxide by downregulating the expression of TF improve bleeding in the early stage of leukemia.