急性白血病化疗后并发败血症患者凝血功能异常与感染相关指标的关系及临床意义的分析  

Analysis of the Relationship between Abnormal Coagulation Function and Infection Related Indicators and Its Clinical Significance in Patients with Acute Leukemia after Chemotherapy Complicated with Septicemia

作　　者：熊丹[1] 李末娟 

机构地区：[1]广东医学院附属医院,广东湛江524000 [2]广东省湛江市第二人民医院

出　　处：《中国医学创新》2015年第32期33-36,共4页Medical Innovation of China

基　　金：2015年湛江市非资助科技攻关计划项目(2015B01097)

摘　　要：目的:探讨急性白血病化疗后并发败血症患者凝血功能异常与感染相关指标的关系及临床意义的分析。方法:回顾性分析128例急性白血病化疗后并发感染的患者的病例资料,根据有无败血症及蛋白水平高低分为败血症组(n=47)、非败血症组(n=42)及非败血症低蛋白组(n=39),检测凝血功能指标与感染相关炎性指标,分析其中关系及临床意义。结果:败血症组患者D-二聚体(D-D)、血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、降钙素原(PCT)、超敏C反应蛋白(CRP)及红细胞沉降率(ESR)检测值均显著高于非败血症组,纤维蛋白原(FIB)检测值显著低于非败血症组;差异均有统计学意义(P<0.05);败血症组经抗感染治疗显效后,D-D、PT、APTT、PCT、CRP及ESR检测值均显著降低,而FIB检测值显著上升(P<0.05);PCT与APTT、D-D的Spearman相关性分析提示,PCT检测值与APTT及D-D呈正相关(P<0.05)。结论:急性白血病化疗后并发败血症患者凝血功能异常与血液细菌性感染炎症反应密切相关,败血症患者的感染炎症水平、并发凝血功能异常的风险均显著高于非败血症组。Objective：To investigate the analysis of relationship between abnormal coagulation function and infection related indicators and its clinical significance in patients with acute leukemia after chemotherapy complicated with septicemia.Method：The clinical data of 128 patients with acute leukemia after chemotherapy concurrent infection were retrospectively analyzed,they were divided into the sepsis group for 47 cases,the non-sepsis group for 42 cases and the non-sepsis low protein group for 39 cases according to the presence of sepsis and protein level.The blood coagulation function indicators and infection related inflammatory indicators were detected,and its relationship and clinical significance were analyzed.Result：The detection values of D-dimer（D-D）,plasma prothrombin time（PT）,activated partial prothrombin time（APTT）,procalcitonin（PCT）,hypersensitive C-reactive protein（CRP） and rythrocyte sedimentation rate（ESR） in the sepsis group were significantly higher than the non-sepsis group,the detection value of fibrinogen（FIB） was significantly lower than the non-sepsis group,the differences were statistically significant（P〈0.05）.After anti infection treatment,the detection value of D-D,PT,APTT,PCT,CRP and ESR in the sepsis group were significantly reduced,the FIB detection value was significantly increased（P〈0.05）,PCT and APTT,D-D Spearman correlation analysis showed that PCT test values were positively correlated with APTT and D-D（P〈0.05）.Conclusion：The abnormal coagulation function in patients with acute leukemia after chemotherapy is closely related to the inflammatory response of blood bacterial infection,the cellular level of inflammation and risk of concurrent coagulation in patients with sepsis infection are significantly higher than non-sepsis patients.

关 键 词：急性白血病 败血症 凝血功能 感染相关指标 

分 类 号：R733.71[医药卫生—肿瘤]