急性白血病患者血浆D-二聚体、血管性血友病因子、抗凝血酶Ⅲ、纤维蛋白原水平表达及意义  

The expression and significance of DD,vWF,AT-Ⅲ and FIB in blood plasma of patients with acute leukemia

作　　者：张海茂[1] 赵风雪 田可港 张蓉[1] 张美莲[1] ZHANG Haimao;ZHAO Fengxue;TIAN Kegang;ZHANG Rong;ZHANG Meilian(Department of Clinical Laboratory,Second Affiliated Hospital of Qingdao University Medical College,Qingdao,Shandong 266042,China)

机构地区：[1]青岛大学医学院第二附属医院检验科,山东青岛266042

出　　处：《国际检验医学杂志》2018年第17期2126-2130,共5页International Journal of Laboratory Medicine

基　　金：山东省医药卫生科技发展计划项目(2015ws0318)

摘　　要：目的探讨急性白血病(AL)患者血浆D-二聚体(DD)、血管性血友病因子(vWF)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白原(FIB)水平的表达及意义。方法选取该院2013年1月至2017年1月收治的79例AL患者,设为AL组,采取化疗方案予以诱导缓解治疗。并选取25例同期体检健康者为对照组。运用胶乳比浊法测定DD和vWF水平、发色底物法检测AT-Ⅲ水平、凝固法测定FIB水平,并计算原始及幼稚细胞比例(即瘤负荷)。结果与对照组比较,AL组治疗前血浆DD和vWF水平均明显上升(P<0.05),AT-Ⅲ与FIB水平均明显降低(P<0.05)。与AML组和ALL组同期相比,APL组治疗前血浆DD、vWF水平,均明显更高(P<0.05);AT-Ⅲ、FIB水平,均明显更低(P<0.05)。但AML组与ALL组以上血浆凝血指标对比差异均无统计学意义(P>0.05)。与治疗前比较,AL组治疗后达完全缓解(CR)时血浆DD、vWF、AT-Ⅲ及FIB水平,均逐渐恢复正常,差异均有(P<0.05);AL组治疗后达未缓解(NR)时以上凝血指标均无明显改变(P>0.05)。经pearson相关性分析,治疗前AL组血浆DD、vWF水平与瘤负荷,均呈正相关(r=0.397、0.437,P<0.05);但AT-Ⅲ、FIB水平与瘤负荷,均呈明显负相关(r=-0.364、-0.341,P<0.05)。结论血浆DD、vWF、AT-Ⅲ、FIB水平能有效反映AL患者病情变化,可作为临床了解AL病情进展、指导用药及预后判断的辅助参考指标。Objective To study the expression and significance of of D-dimer （DD）,von willebrand factor （vWF）,antithrombin Ⅲ （AT-Ⅲ） and fibrinogen （FIB） in blood plasma of patients with acute leukemia （AL）. Methods 79 cases of patients with AL admitted in our hospital from January 2013 to January 2017 were selected to form AL group for the study.The patients were treated with chemotherapy regimen as induction therapy.And another 25 healthy people were chosen to form the control group.The DD and vWF levels were detected by latex turbidity,AT-Ⅲby chromogenic substrate assay and FIB by clotting assay.And ratio of primitive cells to young cells （tumor load） was worked out. Results Before treatment,AL group had much higher DD and vWF levels but much lower AT-Ⅲ and FIB levels than the control group （ P 〈0.05）.Compared with those of AML groups and ALL groups in a same period,the DD and vWF levels of the APL group before treatment were significantly higher （ P 〈0.05） and AT-Ⅲ and FIB levels much lower （ P 〈0.05）.There was no big difference in the aforementioned coagulation parameters between AML and ALL （ P 〉0.05）.The DD,vWF,AT-Ⅲ and FIB levels of AL group gradually restored when achieving complete remission （CR） after treatment with a statistic difference as compared with those before treatment （ P 〈0.05）.No obvious change was seen in the aforesaid parameters when AL group achieving non remission after treatment （ P 〉0.05）.Based on pearson correlation analysis,before treatment the DD and vWF levels were positively correlated with the tumor load （ r =0.397,0.437, P 〈0.05）,while AT-Ⅲ and FIB levels had a negative correlated with the tumor load （ r =-0.364,-0.341, P 〈0.05）. Conclusion Be able to mirror the state of illness of patients with AL,the DD,vWF,AT-Ⅲ and FIB levels can be taken as reference for AL progression,medication,and prognosis as well.

关 键 词：急性白血病 D-二聚体 血管性血友病因子 抗凝血酶Ⅲ 纤维蛋白原 

分 类 号：R446.11[医药卫生—诊断学]