外周血涂片镜检联合纤维蛋白(原)降解产物、D-二聚体检测在急性早幼粒细胞白血病早期诊断中的应用

Application of peripheral blood smear microscopy examination combined with FDP and D-D detections in early diagnosis of acute promyelocytic leukemia

目的分析急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)患者初诊时,外周血涂片镜检异常早幼粒细胞检出率以及纤维蛋白(原)降解产物(FDP)、D-二聚体(D-D)水平,探讨两者在APL早期诊断中的作用。方法回顾性分析2014年1月-2017年12月在本院初诊并最终确诊为APL患者35例,按外周血白细胞计数高低分为正常组、升高组、降低组,统计外周血涂片镜检异常早幼粒细胞检出率,并对漏检情况进行分析;同时检测患者FDP、D-D水平,与对照组比较。结果 APL初诊患者一次血涂片镜检异常早幼粒细胞检出率为88.57%,二次镜检异常早幼粒细胞检出率为94.29%,白细胞降低组患者漏检率较高;与对照组比较,APL初诊患者FDP、D-D含量明显增高,差异有统计学意义(P <0.01)。结论外周血涂片镜检能有效地筛查出高度疑似APL患者,联合FDP、D-D检测在急性早幼粒细胞白血病的初筛、早期诊断中具有重要的临床意义。

Objective To detect the rate of abnormal promyelocytic cells by peripheral blood smear microscopy and the levels of FDP and D-D in patients with acute promyelocytic leukemia, so as to explore the role in early diagnosis of APL. Methods To retrospectively analyze 35 cases of APL diagnosed in our hospital from January 2014 to December 2017. According to leucocyte count, the patients were divided into normal group, elevated group, and decreased group. The detection rate of peripheral blood smear was counted, the situation of missing detection was analyzed. FDP and D-D levels in patients were detected and compared with the control group. Results The detection rate of abnormal promyelocyte in the first blood smear microscopic examination of APL patients was 88. 57%, the detection rate in secondary microscopy examination was 94. 29%. The rate of missed detection was high in patients with decreased APL;compared with the control group, the levels of FDP and D-D obviously rose, and the differences were statistically significant (P <0. 05). Conclusion Peripheral Blood smear microscopy can effectively screen patients with suspected APL. Combined detection of FDP and D-D has important clinical significance in the initial screening and early diagnosis of acute promyelocytic leukemia.