异基因造血干细胞移植前后凝血功能的动态改变  

The Dynamic Alterations of Coagulation in Patients Following Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：夏凌辉[1] 方峻[1] 魏文宁[1] 游泳[1] 谢薇[1] 陈红霞[1] 宋善俊[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院血液病研究所,武汉430022

出　　处：《血栓与止血学》2007年第1期8-11,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的观察异基因造血干细胞移植(allo-HSCT)后凝血功能的动态变化并分析其特点。方法检测28例allo-HSCT患者移植预处理前、移植0 d、移植后7 d、14 d、28 d血浆D-二聚体(D-D)、抗凝血酶(AT)、凝血酶原时间(PT)、活化部分活酶时间(aPTT)、凝血酶凝固时间(TT)、凝血因子Ⅷ活性(FⅧ:C)及纤维蛋白原(Fbg)的动态变化。结果与移植预处理前相比,移植0 d时aPTT明显缩短(P<0.01);PT于移植后7 d和14 d极显著长于移植预处理前水平(P<0.01);Fbg于移植后7 d和14 d较预处理前有极显著性增高(P<0.01);血浆FⅧ:c水平于移植0 d和移植后14 d均显著高于移植预处理前水平(P<0.05)。未见D-D、AT、TT的动态改变存在显著性变化。结论allo-HSCT后可出现凝血功能异常,进一步对allo-HSCT后止凝血发生机制的研究极为必要。Objective To observe the dynamic changes of coagulation in patients following allogeneic hematopoietic stem cell transplantation （ allo- HSCT） and analyze the features of coagulant abnormalities. Methods Plasma samples were collected before the conditioning and on day 0,7,14,28 following allo- HSCT from 28 patients. The following parameters were measured ： D-dimer, antithrombin （AT） , prothrombin time（ PT）, activated partial thromboplastin time（ aPTT）, thrombin clotting time（TF）, factor vm（Fvm） ： C and fibrinogen（Fbg）. Results Compared with the values before conditioning, a significant decline in the aPTT values was detected on day 0 following allo-HSCT; A significant rise in the PT and Fbg values was detected on day on day 7 and day 14 after allo-HSCT; A significant rise in the FⅧ ：C was detected on day 0 and day 14 following allo-HSCT. Other coagulation parameters investigated （D-dimer, AT and TF）remained essentially unchanged. Conclusion The abnormalities in coagulation can be result of conditioning following allo- HSCT. It is very necessary to further investigate the mechanism of hemostatic abnormalities after allo-HSCT.

关 键 词：造血干细胞移植 异基因 凝血功能 

分 类 号：R457.7[医药卫生—治疗学]