化疗后血小板减少急性白血病患者血浆FⅩⅢ、TK1及vWF的表达及其与出血程度的关系

Expressions of serum FⅩⅢ,TK1 and vWF in acute leukemia patients with thrombocytopenia after chemotherapy and their relationship with the bleeding

目的探讨化疗后血小板减少急性白血病(AL)患者血浆凝血因子ⅩⅢ(FⅩⅢ)、胸苷激酶1(TK1)、血管性血友病因子(vWF)的表达及与出血程度的关系。方法选取2020年1月至2022年12月安阳地区医院收治的87例化疗后血小板减少的AL患者作为AL组,另选取同期在安阳地区医院体检的健康者52例作为对照组。AL患者根据是否出血分为出血组(56例)与未出血组(31例)。采用酶联免疫吸附法(ELISA)检测各组血浆FⅩⅢ、TK1、vWF表达水平,分析血浆FⅩⅢ、TK1、vWF表达水平与出血程度的关系。结果AL组血浆TK1、vWF水平高于对照组,FⅩⅢ低于对照组(P<0.05)。出血组血小板(PLT)≤10×10^(9)/L概率及血浆TK1、vWF水平高于未出血组,血浆FⅩⅢ水平低于未出血组(P<0.05)。不同出血程度患者间血浆FⅩⅢ、TK1、vWF水平存在显著差异,且随出血评分增加,血浆FⅩⅢ水平逐渐降低,TK1、vWF水平逐渐升高(P<0.05)。Spearman相关性分析显示,AL患者出血评分与FⅩⅢ呈负相关(r=-0.681,P<0.001),与TK1、vWF呈正相关(r=0.637、0.711,P<0.001)。结论骨髓抑制期的血小板减少急性白血病患者血浆FⅩⅢ表达水平偏低,TK1、vWF表达水平偏高,三者均能有效评价患者出血程度。

Objective To investigate the expressions of plasma coagulation factor ⅩⅢ(FⅩⅢ),thymidine kinase 1(TK1),von Willebrand factor(vWF)and their relationship with the degree of bleeding in acute leukemia(AL)patients with thrombocytopenia after chemotherapy.Methods Eighty-seven AL patients with thrombocytopenia after chemotherapy admitted to Anyang District Hospital from January 2020 to December 2022 were selected as the AL group,another 52 healthy individuals who underwent physical examinations during the same period were selected as the control group.The AL patients were divided into bleeding group(56 cases)and non-bleeding group(31 cases)according to whether there was bleeding.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of plasma FⅩⅢ TK1,and vWF in the different groups,and analyze the relationship between plasma FⅩⅢ TK1,vWF expression levels and bleeding severity.Results The plasma TK1 and vWF levels in the AL group were higher than those in the control group,while FⅩⅢlevels were lower than those in the control group(P<0.05).The probability of platelet(PLT)≤10×10^(9)/L and plasma TK1 and vWF levels in bleeding group were higher than those in non-bleeding group,and plasma FⅩⅢ levels were lower than those in non-bleeding group(P<0.05).The plasma levels of FⅩⅢ,TK1 and vWF were significantly different among patients with different bleeding degrees,and with the increase of bleeding score,the plasma levels of FⅩⅢ were gradually decreased,and the levels of TK1 and vWF were gradually increased(P<0.05).Spearman correlation analysis showed that the bleeding score of AL patients was negatively correlated with FⅩⅢ(r=-0.681,P<0.001),and positively correlated with TK1 and vWF(r=0.637,0.711,P<0.001).Conclusions The expression level of plasma FⅩⅢ in patients with thrombocytopenic acute leukemia is low,and the expression levels of TK1 and vWF are high,three of which can effectively evaluate the degree of bleeding in patients.