摘要
目的:探讨急性白血病(AL)患儿并发弥散性血管内凝血(DIC)早期及干预后血凝指标变化。方法:本实验分3组即健康对照组;AL组;AL并发DIC组,均于清晨抽取空腹血检测D-二聚体(DD)、纤维蛋白原水平(FBG)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及抗凝血酶-Ⅲ(AT-Ⅲ)。对AL并发DIC组患儿应用低分子肝素治疗,比较治疗前后各指标变化,采用SPSS10.0软件将各组进行统计学分析。结果:AL组与健康对照组比较,PT延长,FBG降低,DD明显升高,差异有统计学意义(P<0.05),AL并发DIC组与AL组比较,DD明显升高,AT-Ⅲ降低,差异有统计学意义(P<0.05),且与AL组相比,AL并发DIC组DD、AT-Ⅲ阳性率明显升高,且在DIC发病的不同临床阶段均保持在较高水平(80%以上),DD检测阳性率在血栓形成期高达100%。经肝素抗凝治疗后,AT-Ⅲ及FBG明显升高,DD降低,差异有统计学意义(P<0.05)。结论:AL并发DIC患儿存在凝血、纤溶系统的激活,AT-Ⅲ及DD可作为DIC早期诊断的指标,低分子肝素应用有助于改善DIC患儿的预后。
Objective： To explore the early changes of blood coagulation indictors in acute leukemia children complicated with disseminated intravascular coagulation （DIC） and the efficacy of low molecular weight heparin in- tervention. Method：The cases in our experiment were divided into three groups： the healthy control group, AL group and Air complicated with D1C group. Plasma level of AT-Ⅲ , D-dimer, fibrinogen, activated partial thromboplastin time and prothrombin time were detected. The changes of indictors before and after treatment with low molecular weight heparin in AL group complicated with DIC were compared. And the results were compared be- tween the three groups by SPSS 10. 0 software. Result：PT prolonged, fibrinogen reduced and the D-direct in- creased significantly in AL group than those in healthy control group （P〈0.05）. The plasma level of D-dimer in AL complicated with D1C group was significantly higher and the activities of AT-Ⅲ was significantly lower than those in AL group （P〈0.05）. The positive rate of these indexes highly increased and maintained at high level in the different clinical stages （higher than 80% ）. The positive rate of the D-dimmer can up to 100% in the thrombus formation period of DIC. After heparin treatment, AT-Ⅲ and FBG increased but D-dimmer reduced significantly （P〈0.05） Conclusion： AL children complicated with DIC has important impacts on coagulation and fibrinolytic function. AT-Ⅲ and D-dimer may be used for early diagnosis of DIC. Low molecular weight heparln was helpful to improve the prognosis of children with DIC.
出处
《临床急诊杂志》
CAS
2012年第3期155-157,共3页
Journal of Clinical Emergency
关键词
弥散性血管内凝血
急性白血病
D-二聚体
抗凝血酶-Ⅲ
低分子肝素
disseminated intravascular coagulation
acute leukemia
D-dimer
antithrombin activity
low molecular weight heparin
