急性白血病凝血与纤溶指标的临床观察

Clinical observation on blood coagulation and fibrinolysis in acute leukemia

本文采用发色多肽底物法及常规出凝血试验方法,测定20例未治疗AL的BPC、TFA、PLG、PK、Fbg,FDP等凝血与纤溶指标,结果:AL组TFA、PLG、PK与正常对照组无显著差别,提示多数AL不伴纤溶系统的激活;但AL组FDP、Fbg升高较正常对照组相差非常显著。重度出血组纤溶活性较无出血组明显增强,提示纤溶亢进可能是重度出血的主要原因之一。3例AL各指标的动态观察结果为,AL病情缓解后,FDP、Fbg均呈下降趋势,提示FDP与Fbg动态测定对临床观察病情有一定帮助。

Plasma prekallikrein,total fibrinolytic activity (TFA),plasmi-nogen (PLG),fibrinogen (Fbg) and fibrin(ogen) degradation products (FDP) were determined with chromogenic peptide substrate (CPS) and routine hema-tologic methods in 20 patients with untreated acute leukemia.It was found that the activities of blood coagulation and fibrinolysis showed no significant difference between leukemic patients and the normal controls;marked elevation of FDP and Fbg was observed in leukemic patients;the activity of fibrinolysis was significantly higher in the leukemic cases with severe bleeding than in those cases with slight or little bleeding.In addition,a tendency of continuous lowering of FDP.and Fbg levels was observed in a dynamic observation of 3 acute leukemic cases.On the basis of these findings,it might be concluded that no activation of the fibrinolysis system occurs in most cases of acute leukemia;excessive fibrinolysis may be one of the factors to induce severe hemorrhage;the levels of FDP and Fbg are lower in the patients in remission stage than in those in active or relapse stage.Successive determination of FDP and Fbg levels is helpful to assess the conditions of a leukemic patient.