摘要
目的探讨D-二聚体(D-dimer,D-D)、纤维蛋白降解产物(fibrin degradation product,FDP)、血栓调节蛋白(thrombomodulin,TM)、凝血酶–抗凝血酶复合物(thrombin-antithrombin complex,TAT)、组织型纤溶酶原激活物–纤溶酶原激活物抑制剂–1复合物(tissue plasminogen activator-plasminogen activator inhibitor-1 complex,t-PAIC)及纤溶酶–α2抗纤溶酶复合物(plasmin-alpha 2 plasmin inhibitor complex,PIC)在急性髓系白血病(acute myeloid leukemia,AML)患者治疗过程中的水平变化及对疗效和预后的预测价值。方法收集2022年1月至2024年12月于广西壮族自治区桂东人民医院初诊的31例AML患者作为观察组,另选取34名健康体检者作为对照组。比较两组纳入者的指标水平及观察组患者治疗前、中、后各指标的变化,根据疗效标准将观察组分为缓解组和未缓解组,进一步比较缓解组与未缓解组患者的指标水平。利用Logistic回归分析探讨AML患者疗效及预后的危险因素。结果治疗前,观察组患者的凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial thromboplastin time,APTT)、D-D、FDP、t-PAIC、PIC、TM及TAT水平均显著高于对照组(P<0.05),纤维蛋白原(fibrinogen,Fib)与对照组比较差异无统计学意义(P>0.05)。治疗中,观察组患者的t-PAIC和TM水平较治疗前升高(P<0.05);治疗后,观察组患者的PT、D-D、FDP、PIC及TAT水平较治疗前明显降低(P<0.05);治疗后的PT、D-D、FDP、t-PAIC、PIC、TM及TAT均低于治疗中(P<0.05)。未缓解组患者的D-D、FDP、t-PAIC、PIC、TAT及TM水平均高于缓解组,其中t-PAIC和TM比较差异有统计学意义(P<0.05)。二元Logistic回归分析显示,t-PAIC是影响AML患者疗效及预后的独立危险因素(P<0.05,OR=1.205,95%CI:1.015~1.430)。结论定期检测D-D、FDP、TM、TAT、t-PAIC及PIC水平,有助于评估AML患者的病情变化和疗效预后,为临床决策提供参考。
Objective To investigate the changes in the levels of D-dimer(D-D),fibrin degradation product(FDP),thrombomodulin(TM),thrombin-antithrombin complex(TAT),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC),and plasmin-alpha 2 plasmin inhibitor complex(PIC)during the treatment of patients with acute myeloid leukemia(AML)and their predictive value for efficacy and prognosis.Methods Thirty-one AML patients initially diagnosed at Guidong People’s Hospital of Guangxi Zhuang Autonomous Region from January 2022 to December 2024 were collected as observation group,and 34 healthy medical checkupers were selected as control group.The changes in the levels of the indicators between two groups as well as before,during and after the treatment of observation group were compared,and observation group was divided into remission group and non-remission group according to the efficacy criteria,and the levels of the indicators between two groups were further compared.Risk factors for the efficacy and prognosis of AML patients were analyzed by using Logistic regression analysis.Results Before treatment,the levels of prothrombin time(PT),activated partial thromboplastin time(APTT),D-D,FDP,t-PAIC,PIC,TM and TAT in observation group were significantly higher than those in control group(P<0.05),whereas there was no significant difference in fibrinogen(Fib)compared with control group(P>0.05).During the treatment,the levels of t-PAIC and TM in observation group were higher than those before treatment(P<0.05);After treatment,the levels of PT,D-D,FDP,PIC and TAT in observation group were significantly lower than those before treatment(P<0.05).After treatment,the levels of PT,D-D,FDP,t-PAIC,PIC,TM and TAT were all lower than those during treatment(P<0.05).The D-D,FDP,t-PAIC,PIC,TAT and TM levels in non-remission group were all higher than those in remission group,with the t-PAIC and TM levels showing statistical significance(P<0.05).Binary Logistic regression analysis showed that t-PAIC was an independent risk factor affecting the efficacy and prognosis of AML patients(P<0.05,OR=1.205,95%CI:1.015-1.430).Conclusion Regular testing of D-D,FDP,TM,TAT,t-PAIC and PIC levels can help to assess the disease changes and efficacy prognosis of AML patients,and provide an important reference for clinical decision-making.
作者
龚莉
罗锦英
陈国宁
童广福
王晓刚
GONG Li;LUO Jinying;CHEN Guoning;TONG Guangfu;WANG Xiaogang(Department of Blood Transfusion,Guidong People’s Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543001,Guangxi,China;Department of Clinical Laboratory,Guidong People’s Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543001,Guangxi,China;Department of Hematology,Rheumatology,and Immunology,Guidong People’s Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543001,Guangxi,China)
出处
《中国现代医生》
2025年第27期19-22,92,共5页
China Modern Doctor
基金
贺州市科学研究与技术开发计划项目(贺科技2023111)。
关键词
急性白血病
凝血指标
纤溶指标
血栓调节蛋白
预后
Acute leukemia
Coagulation index
Fibrinolytic index
Thrombomodulin
Prognosis
