摘要
目的 观察急性白血病 (AL)患者止、凝血分子标志物的变化以探索其在AL诊断、治疗及预后判断中的意义。方法 用ELISA法检测 82例AL患者血浆组织因子 (TF)、组织因子途径抑制物(TFPI)、凝血酶 抗凝血酶复合物 (TAT)、尿激酶型纤溶酶原激活物 (u PA)、尿激酶型纤溶酶原激活物受体 (u PAR)、纤溶酶 抗纤溶酶复合物 (PAP)。结果 治疗前 ,AL患者TF、TAT、u PA、u PAR显著增高。急性髓系白血病 (AML)患者TFPI、PAP值异常增高。治疗后 ,TF、TAT在AML患者中维持高水平 ;u PA、u PAR在未缓解者持续增高 ;出血严重者PAP、u PA显著升高。结论 不同类型AL患者的止凝血功能异常存在差异 ,可随病情好转逐渐改善。TF、TAT、PAP有助于弥散性血管内凝血防治 ;u PA、u PAR可作为部分AML预后判断的指标。严重出血者需联合应用抗纤溶药。
Objective To study the changes of hemostatic molecular markers in acute leukemia(AL) for elucidating their clinical significance. Methods A series of hemostatic molecular markers,including TF、TFPI、TAT、PAP、u PA and u PAR were measured in 82 acute leukemia. Results The plasma levels of TF、TAT、u PA and u PAR were elevated significantly at diagnosis in all AL patients tested,while TFPI、PAP did only in AML. After treatment, TF and TAT remained high in AML, u PA and u PAR were still high in un remission patients. PAP and u PA remarkably elevated in patients with severe hemorrhage. Conclusions There existed hemostatic abnormality as well as hyperfibrinolysis, which varied with leukemia types and was ameliorated with clinical improvement. The measurement of TF、TAT and PAP may provide useful information for the diagnosis of DIC. u PA and u PAR may be considered as a useful indicator for prognosis. Patient with severe hemorrhage should be treated with antifibrinolysis drugs. The prevention of hypercoagulability after treatment should be kept in mind.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2001年第3期141-144,共4页
Chinese Journal of Hematology
