恶性血液病凝血指标的变化及意义

    Changes of blood coagulation index in patients with malignant hematopathy and their clinical significance

    • 摘要: 目的: 探讨恶性血液系统疾病凝血指标的改变及其临床意义。方法: 回顾性分析135例血液肿瘤患者初发时凝血指标的差异,并总结急、慢性白血病及恶性淋巴瘤、多发性骨髓瘤凝血指标的变化。结果: 急性白血病、淋巴瘤、多发性骨髓瘤凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和D-二聚体(D-D)与正常对照组差异均有统计学意义(P<0.05~P<0.01),纤维蛋白原(FIB)、纤维蛋白降解产物(FDP)与正常对照组差异均无统计学意义(P>0.05),而慢性白血病各项指标与对照组差异均无统计学意义(P>0.05),急性白血病组中急性非淋巴细胞白血病-M3凝血指标PT、APTT、D-D、FDP与其他各组差异均有统计学意义,各组FIB差异无统计学意义(P>0.05),淋巴瘤组中霍奇金组与非霍奇金组各项凝血指标差异均无统计学意义(P>0.05)。结论: 恶性血液病患者存在凝血、纤溶异常,通过测定FIB、D-D、FDP等指标,可早期判断患者是否处于高凝状态,为及时干预治疗提供客观依据。通过对PT、APTT的监测,可为弥散性血管内凝血的发生及临床用药监测提供实验依据。

       

      Abstract: Objective: To explore the significance of the changes of blood coagulation index in patients with malignant blood system diseases.Methods: The difference of the blood coagulation index in 135 patients with malignant neoplastic hematologic disorder was analyzed retrospectively,and the changes of the blood coagulation index in patients with acute leukemia (AL),chronic leukemia (CL),lymphoma and multiple myelomaly were summarized.Results: The prothrombin time (PT),activated partial thromboplastin time (APTT),D-dimer (D-D) and fibrin degradation product (FDP) in patients with AL,lymphoma and multiple myelomaly were significantly different from those of the normal control (P<0.05-P<0.01);the PT,APTT,D-D and FDP between M3 sabutype AL and non-M3 abutype AL in patients with acute lymphoblastic leukemia differed significantly (P<0.05) compared with those in other groups;the fibrinogen (FIB) presented no significant difference among the groups (P>0.05).The blood coagulation index in patients with lymphoma was not statistically different (P>0.05).Conclusions: The coagulation and fibrinolysis are abnormal in patients with hematological malignancy.Detection of FIB,D-D and FDP may help to judge whether the patients are in a state of hypercoagulability,which will provide basis for early intervention;detection of PT and APTT may provide evidence for the occurrence of disseminated intravascular coagulation and the application of clinical medication.

       

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