白血病骨髓抑制期血浆凝血因子XIII与出血事件的相关性

Correlation between plasma coagulation factor XIII and bleeding events in leukemia during myelosuppression

目的 探讨白血病骨髓抑制期血浆凝血因子XIII与出血事件的相关性。方法 选取2018年5月至2020年5月本院收治的146例白血病患者作为研究对象,根据患者骨髓抑制期是否出现出血事件分为出血组(n=88)和未出血组(n=58)。比较两组临床资料[性别、年龄、病程、血小板计数≤20×10~9/L占比、活化部分凝血活酶时间(APTT)延长、凝血酶原时间(PT)延长、医院感染、基础疾病]、血浆凝血因子XIII;采用单因素及多因素Logistic分析白血病化疗患者骨髓抑制期发生出血的相关因素。结果 单因素分析结果显示,两组性别、年龄、病程及基础疾病占比比较差异无统计学意义;两组APTT延长、PT延长、血小板计数≤20×109/L和医院感染占比及血浆凝血因子XIII比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析血浆凝血因子XIII和血小板计数≤20×109/L是影响白血病化疗患者骨髓抑制期发生出血的保护因素(OR<1,P<0.05),APTT延长则是危险因素(OR>1,P<0.05)。结论 白血病化疗患者骨髓抑制期血浆凝血因子XIII指标有所降低,且出血后血浆凝血因子XIII水平下降,其是导致白血病化疗患者骨髓抑制期发生出血的危险因素。

Objective To investigate the correlation between plasma coagulation factor XIII and bleeding events in leukemia during myelosuppression.Methods 146 leukemia patients admitted to our hospital from May 2018 to May 2020 were selected as the research subjects,and they were divided into bleeding group(n=88) and non-bleeding group(n=58) according to whether the patients had bleeding events during the period of bone marrow suppression.The clinical data(sex,age,course of disease,proportion of platelet count ≤20×109/L,prolonged activated partial thromboplastin time [APTT],prolonged prothrombin time [PT],nosocomial infection,underlying diseases),plasma coagulation factor XIII between the two groups were compared;Univariate and multivariate Logistic were used to analyze the related factors of bleeding in patients with leukemia undergoing chemotherapy during myelosuppression.Results Univariate analysis showed that,there was no significant difference in sex,age,course of disease and the proportion of underlying diseases between the two groups;there were significant differences in APTT prolongation,PT prolongation,proportion of platelet count ≤20×109/L,the proportion of nosocomial infection and plasma coagulation factor XIII between the two groups(P1,P<0.05).Conclusion The level of plasma coagulation factor XIII decreased in patients with leukemia chemotherapy during the myelosuppression stage,and the level of plasma coagulation factor XIII decreased after bleeding,which is a risk factor for bleeding in the myelosuppression stage of leukemia chemotherapy patients.