弥漫性血管内凝血与急性髓系白血病的血栓形成相关性的探讨  

Discussion of Disseminated Intravascular Coagulation and Thrombosis in Acute Myeloid Leukemia

作　　者：张辉[1] 刘徽 许玉玲 邓东红[1] 刘振芳[1] 程鹏[1] 

机构地区：[1]广西医科大学第一附属医院血液科,南宁530000

出　　处：《血栓与止血学》2018年第1期5-6,9,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨显性弥漫性血管内凝血(DIC)评分对诊断急性髓系白血病(AML)的血栓形成预测的评估。方法对广西医科大学第一附属医院血液科126例初治急性髓细胞白血病患者进行研究,评估弥散性血管内凝血(DIC)的标志物和国际血栓与止血协会的DIC评分与随访期间血栓形成的关系。结果在平均周期为210天的随访中,患者的血栓发生率为5.9%。第一个疗程的化疗后血栓形成事件的发生率为62.5%。血栓的形成与高DIC评分(大于5)的危险比(HR)为19.15,高D二聚体水平(≥4 mg/L)的危险比(HR)为9.52。结论大约5.9%AML患者经过强力化疗后可能存在血栓形成,急性髓细胞白血病患者血栓形成事件可以通过DIC的存在来预测。Objective To discuss the correlation of Disseminated intravascular coagulation （DIC） and thrombosis in acute myeloid leukemia（AML）. Methods In the study in a cohort of 126 patients with newly diagnosed AML, we assessed markers of disseminated intravascular coagulation （ DIC ） and the DIC score according the International Society of Thrombosis and Haemostasis and their associations with the occurrence of venous and arterial thrombosis during follow-up. Results The prevalence of thrombosis was 5.9% over a median follow-up of 210 days. Most thrombotic events （62. 5% ）occurred after the end of the first course of chemotherapy. The calculated DIC score significantly predicted thrombosis with a hazard ratio （HR）for a high DIC score（ ≥5 ）of 19. 15 ,D-dimer levels are most predictive for thrombosis with an HR of 9.52. Conclusion Thrombosis may develop 5.9% of AML patients treated with intensive chemotherapy, which to a large extent can be predicted by the presence of DIC at time of AML diagnosis.

关 键 词：急性髓细胞白血病 血栓 弥漫性血管内凝血 

分 类 号：R733.4[医药卫生—肿瘤]