急性早幼粒细胞白血病患者血栓弹力图检测的临床意义  

The Clinical Significance of Thrombelastography in Patients with Acute Promyelocytic Leukemia

作　　者：王玉婷[1] 李艳[2] 郝一文[1] 马怡然[1] 肖萌[3] 王林林[1] 

机构地区：[1]中国医科大学附属第一医院输血科,沈阳110001 [2]中国医科大学附属第一医院血液科,沈阳110001 [3]山东省济宁市第一人民医院血液科,济宁272002

出　　处：《血栓与止血学》2012年第6期264-267,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨血栓弹力图(TEG)在评价急性早幼粒细胞白血病(APL)患者体内凝血状态中的作用。方法对23例APL患者初治时与完全缓解时进行TEG测定,了解其凝血功能情况。并与24例健康体检者的TEG相比较。结果 23例初治APL患者中有22例(95.65%)的TEG表现为低凝图像,R、K明显延长,Angle、MA、G及CI明显变小,与正常对照组相比较,差异具有统计学意义(P<0.05)。与完全缓解后相比亦差异显著(P<0.05)。TEG检测的多项参数与常规凝血指标有相关性,K时间与PT呈正相关;Angle角与PT相关,与Fbg呈负相关;MA及G与PT负相关,与PLT计数呈正相关;CI与PT负相关。结论 APL患者体内存在病理性低凝状态,应用TEG动态观察其凝血状态,对病情评估及指导治疗有重要意义。TEG检测参数不仅可检测患者的凝血紊乱情况,而且与APL患者的PT和血小板计数、纤维蛋白原水平密切相关。Objective To investigate the effect of thrombelastography （TEG） on evaluating the blood coagulating status in acute promyelocytic leukemia （ APL ） patients. Methods The TEG results of 23 APL patients when they were newly diagnosed and in complete remission, compared with those of 24 healthy people,were collected to investigate their coagulating status. Results In 23 newly diagnosed cases,the TEG resuits of 22 cases showed hypocoagulability, in which R.K were significantly prolonged, Angle.MA,G and CI were significantly shortened （ P 〈 0.05 ）, compared with the results of such 23 cases in complete remission and the results of 24 healthy cases. The multiple parameters of TEG were related to the conventional coagulation indexes, K was in positive correlation with PT; Angle was in positive correlation with PT,and in negative correlation with fibrinogen; MA and G were in negative correlation with PT, and in positive correlation with platelet count. ;CI was in negative correlation with PT. Conclusion APL patients are in pathologically hypocoagulability. By observing the coagulating status,TEG plays an tion and treatment instruction. TEG is not only the parameter important role in patient＇ showing the coagulating s condition evaluadisorders, but also bound up with the level of PT,fibrinogen（Fbg） and platelet coun（PLT）.

关 键 词：急性早幼粒细胞白血病 血栓弹力图 

分 类 号：R733.7[医药卫生—肿瘤]