伊马替尼对慢性粒细胞性白血病患者血小板参数、凝血及纤溶功能的影响  

Effect of Imatinib on Platelet Parameters and Coagulation Fibrinolytic Function in Patients with Chronic Myelocytic Leukemia

作　　者：郑丽玲[1] 张青[1] 欧瑞明[1] 谭友平[1] 杜苑苑[1] 

机构地区：[1]广东省第二人民医院血液科,广州510317

出　　处：《血栓与止血学》2017年第6期978-980,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的伊马替尼对慢性粒细胞性白血病(CML)患者血小板参数、凝血及纤溶功能的影响。方法选取我院2006年2月至2016年8月期间CML患者112例作为研究组,同期我院进行体检的健康者112例作为正常对照组。研究组给予伊马替尼治疗。于治疗前和治疗后3个月,检测血小板参数,凝血和纤溶指标,观察并记录患者不良反应。结果研究组治疗前PLT水平显著高于对照组(P<0.05),治疗后PLT水平显著降低(P<0.05),研究组PCT、MPV以及PDW治疗前后与对照组相比,差异没有统计学意义(P>0.05);研究组治疗前Fbg、D-D水平显著高于对照组(P<0.05),治疗后Fbg、D-D水平显著降低(P<0.05),研究组治疗前后PT、TT、a PTT与对照组相比,差异没有统计学意义(P>0.05);非血液学不良反应程度较轻,血液学不良反应:粒细胞减少57例(占50.89%),血小板减少26例(占23.21%),及时减少伊马替尼用量,并给予G-CSF治疗,均好转。结论伊马替尼治疗CML患者,可使血小板计数显著降低,对血小板形态影响不大,可使Fbg、D-D显著降低至正常水平,调节凝血纤溶系统功能。Objective To investigate the effect of imatinib on coagulation function, platelet parameters and fibrinolytic indexes in patients with chronic myelocytic leukemia （CML）in chronic phase. Methods A total of 112 patients with CML admitted to our hospital between February 2006 and August 2016 were selected as the study group, and another 112 healthy people who were admitted to our hospital for physical examination were selected as the normal control group at the same time. The study group were treated with imatinib. The platelet parameters,coagulation function and fibrinolytic indexes were detected before treatment and 3 months after treatment. The adverse reactions were observed and recorded. Results Before treatment,the PLT level was significantly higher in the study group than the control group （P 〈 0.05 ） , and after treatment, PLT levels were significantly decreased （P 〈 0.05 ）. There was no significant difference in PCT, MPV and PDW between the two groups before and after treatment（P 〉 0.05）. The levels of Fbg and D-D were significantly higher in the study group than the control group before treatment （P 〈 0.05）. After treatment,the levels of Fbg and D-D decreased significantly （P 〈 0.05 ）. There was no significant difference in PT, TT and aPTT between the two groups before and after treatment （P 〉 0.05 ）. The non- hematological adverse reactions were mild, and there were hematologica! adverse reactions,such as neutropenia in 57 cases （50. 89% ）and thrombocytopenia in 26 cases （23.21%）. After timely decreasing the dosage of imatinib and treatment with G-CSF, the symptoms were relieved. Conclusion The treatment of CML with imatinib can significantly reduce the platelet count and has little effect on platelet morphology. It can restore the levels of Fbg and D-D to normal levels and regulate between coagulation and fibrinolytic system.

关 键 词：伊马替尼 慢性粒细胞性白血病 血小板 凝血纤溶系统 

分 类 号：R733.72[医药卫生—肿瘤]