摘要
目的:检测急性白血病(AL)患者化疗前后血浆中组织因子(TF)及组织因子途径抑制物(TFPI)的含量变化,探讨血浆TF及TFPI在AL病情进展、疗效观察、预后判断中的意义,为AL患者发生凝血功能异常提供临床诊断和治疗依据。方法:选择2009年7月—2010年2月间住院的各型初诊AL患者48例,正常对照组20例,采集空腹外周肘静脉血,应用酶联免疫吸附法(ELISA)检测AL患者血浆中TF及TFPI的含量,同时检测其他的临床相关指标,比较血浆TF及TFPI含量在AL患者化疗前后的变化。结果:初诊的AL患者经治疗缓解后血浆TF和TFPI含量均较治疗前明显下降,差异有统计学意义;急性早幼粒细胞白血病(APL)患者化疗前血浆TF和TFPI含量均明显高于其他类型AL,APL患者化疗前后血浆TF和TFPI含量均有明显差异;合并DIC组的AL患者血浆TF和TFPI含量均明显高于不合并DIC组的AL,且化疗前后血浆TF和TFPI含量有显著差异。结论:初诊的AL患者血浆中TF和TFPI的含量均明显增高,而治疗缓解后降低,提示血浆中TF和TFPI含量变化与疾病的发生、进展及临床疗效有一定关系;血浆中TF和TFPI含量的升高与DIC的发生密切相关,在一定程度上对DIC的疗效判断具有预示作用。
Objective：To detect the plasma levels of tissue factor（TF）and tissue factor pathway inhibitor（TFPI） in patients with acute leukemia （AL）and explore the clinical significance in the evaluation of development ,curative effect and prognosis of AL patients through comparing the variation TF and TFPI levels in pre-treatment and post- chemotherapy. It can provid us the clinical diagnosis and treatment guideline through monitoring the changes of coagulation in AL patients. Methods ：The levels of TF and TFPI were detected in the peripheral venous blood samples from 20 normal controls ,and 48 newly diagnosed patients with acute leukemia（including 11 patients with acute lymphocytic leukemia （ALL）, 2 patients with M1,9 patients with M2,11 patients with M3,3 patients with M4,12 patients with M5 ） ,by enzyme linked immuno-sorbent assay（ELISA）. Results ：It was found TF and TFPI levels of post-chemothera- py were lower obviously than of pre-treatment. TF and TFPI levels in acute promyelocytic leukemia（APL） were higher significantly than those in patients with AL ,except APL. In APL ,the plasma levels of TF and TFPI after treatment were lower obviously than of pre-treatment. The plasma levels of TF and TFPI from AL patients with disseminated intravascular coagulation （DIC） were higher obviously than those in patients without DIC. In DIC group,the plasma levels of TF and TFPI before treatment were both higher significantly than those after treatment. Conclusions：The plasma levels of TF and TFPI in the newly diagnosed AL patients were higher obviously than those in the normal controls before treatment,but were lower obviously post-chemotherapy than of pre-treatment. It was shown they might participate in the evaluation of development ,curative effect and prognosis of AL patients through comparing the variation TF and TFPI levels in pre-treatment and post-chemotherapy. The plasma levels of TF and TFPI reflect the development of diseases,there was a intimated correlation between the expression of TF 和 TFPI and DIC. In certain degree,TF and TFPI levels might be useful for the prediction of the curative effects of DIC.
出处
《临床医药实践》
2010年第11期842-844,共3页
Proceeding of Clinical Medicine
关键词
组织因子
组织因子途径抑制物
白血病
tissue factor
tissue factor pathway inhibitor
acute leukemia
