及时输注血小板及凝血因子对急性早幼粒细胞白血病患者实验室指标及疗效影响  

Influence of timely platelet and coagulation factor transfusion on laboratory indicators and curative effect of patients with acute promyelocytic leukemia

作　　者：陈勇[1] 凌建 徐容[2] 薛莉 CHEN Yong;LING Jian;XU Rong(Department of Laboratory Medicine,Mianyang People's Hospital,Mianyang Sichuan 621000,China;Department of Hematology,Mianyang People's Hospital,Mianyang Sichuan 621000,China)

机构地区：[1]绵阳市人民医院检验科,四川绵阳621000 [2]绵阳市人民医院血液科,四川绵阳621000 [3]电子科技大学医学院附属绵阳市中心医院医学检验科,四川绵阳621000

出　　处：《临床和实验医学杂志》2021年第24期2679-2682,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省绵阳市卫健委科研基金资助项目(编号:201846)。

摘　　要：目的探讨及时输注血小板及凝血因子对急性早幼粒粒细胞白血病(APL)患者实验室指标及疗效影响。方法回顾性调取2011年1月至2021年1月绵阳市人民医院收治的APL患者97例,依据病情程度分为低危组(n=20)、中危组(n=36)、高危组(n=41),根据早期(化疗开始后第3天内)是否及时给予血小板和凝血因子输注分为早期干预、非早期干预。比较各组血常规[白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)]、凝血相关指标[凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白(FIB)以及D-二聚体(D-D)水平]变化、化疗有效率及住院总费用、总住院时长。结果低、中、高危组早期干预组治疗结束后较非早期干预组的Hb及PLT明显升高,且高危组明显高于低、中危组,差异均有统计学意义(P<0.05);低、中危组早期干预组治疗结束后WBC较非早期干预组比较差异无统计学意义(P>0.05),但高危组早期干预组治疗结束后较非早期干预组WBC明显降低,差异有统计学意义(P<0.05)。中危组早期干预组治疗结束后PT、APTT较非早期干预组明显缩短,D-D明显下降,FIB则明显下降,差异有统计学意义(P<0.05);高危组早期干预组治疗结束后PT、APTT较非早期干预组明显缩短,D-D明显下降,FIB则明显升高,差异有统计学意义(P<0.05)。中、高危组早期干预组化疗有效率明显高于非早期干预组,差异有统计学意义(P<0.05)。早期干预组住院总费用较非早期干预组低,住院总时长较非早期干预组短,但差异无统计学意义(P>0.05)。结论早期及时输注血小板及凝血因子可明显改善APL患者凝血功能和血常规等实验室指标,尤其是高危型APL患者,且利于APL患者化疗效果的提高,在APL患者中有临床推广应用优势。Objective To investigate the influence of timely platelet and coagulation factor transfusion on laboratory indicators and curative effect of patients with acute promyelocytic leukemia(APL).Methods 97 patients with APL treated in Mianyang People's Hospital between January 2011 and January 2021 were retrospectively selected.According to the condition,they were divided into low-risk group(n=20),middle-risk group(n=36),and high-risk group(n=41).According to the application of timely platelet and coagulation factor transfusion in early stage(within 3 days after the beginning of chemotherapy),the patients were divided into early intervention group and non-early intervention group.Changes in blood routine[white blood cell count(WBC),hemoglobin(Hb),platelet count(PLT)]and coagulation-related indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrin(FIB)and D-dimer(D-D)],the effective rate of chemotherapy,total hospitalization cost,and the length of hospital stay were compared between the groups.Results The Hb and PLT of the low-,medium-,and high-risk groups in the early intervention group were significantly higher than those in the non-early intervention group after treatment,and the high-risk group was significantly higher than the low-and medium-risk groups,and the differences were statistically significant(P<0.05).In the low-risk group and the middle-risk group,there was no significant difference in WBC between the early intervention group and the non-early intervention group after 1 week of chemotherapy and blood transfusion(P>0.05).In the high-risk group,WBC of the early intervention group after 1 week of blood transfusion was significantly lower than that of the non-early intervention group after treatment,the differences were statistically significant(P<0.05).The PT and APTT of the early intervention group in the intermediate-risk group were significantly shorter than those in the non-early intervention group,DD was significantly decreased,and FIB was significantly decreased,the difference

关 键 词：输注血小板 急性早幼粒粒细胞白血病 实验室指标 疗效 

分 类 号：R733.71[医药卫生—肿瘤]