急性白血病患者化疗前后血清vWF、TM、FDP水平变化及其与预后的相关性  

Changes of serum von Willebrand factor,thromboregulatory protein,and fibrin degradation product levels levels before and after chemotherapy in acute leukemia patients and their correlation with prognosis

作　　者：史瑞 温静 吴雯 宋艳萍[1] SHI Rui;WEN Jing;WU Wen;SONG Yan-ping(Department of Hematology,Xi'an Central Hospital,Xi'an Institute of Hematology,Xi'an 710004,Shaanxi,CHINA)

机构地区：[1]西安市中心医院(西安市血液病研究所)血液内科,陕西西安710004

出　　处：《海南医学》2022年第23期3064-3067,共4页Hainan Medical Journal

基　　金：陕西省自然科学基础研究项目(编号:2013JM4016)。

摘　　要：目的探讨急性白血病患者化疗前后血清血管性血友病因子(vWF)、血栓调节蛋白(TM)、纤维蛋白降解产物(FDP)水平的变化及其与预后的相关性。方法选择2018年1月至2021年6月西安市中心医院收治的80例急性白血病患者作为观察组,其中急性髓系白血病62例,急性淋巴细胞白血病18例,并选择同期于本院接受体检的80例健康人群作为对照组。比较观察组患者化疗前和对照组健康人群的血清vWF、TM、FDP表达水平,并比较观察组患者化疗前后、不同疗效患者之间的血清vWF、TM、FDP表达水平,采用Pearson相关性分析血清vWF、TM、FDP水平与预后的相关性。结果观察组中急性髓系白血病患者化疗前的血清vWF、TM、FDP水平分别为(112.18±15.92)μg/L、(29.82±2.98)TU/mL、(6.58±1.37)μg/mL,明显高于急性淋巴细胞白血病患者的(80.23±12.57)μg/L、(17.03±2.35)TU/mL、(3.84±0.68)μg/mL和对照组的(28.45±3.28)μg/L、(8.32±1.56)TU/mL、(1.75±0.34)μg/mL,且急性淋巴细胞白血病患者的血清vWF、TM、FDP水平也明显高于对照组,差异均有统计学意义(P<0.05);化疗1个周期后,观察组患者的血清vWF、TM、FDP水平分别为(41.23±3.29)μg/L、(13.03±1.48)TU/mL、(3.02±0.56)μg/mL,明显低于化疗前的(92.18±16.07)μg/L、(25.71±2.97)TU/mL、(5.49±1.25)μg/mL,差异均有统计学意义(P<0.05);观察组患者化疗后完全缓解25例,非完全缓解55例,完全缓解患者的血清vWF、TM、FDP水平分别为(34.23±3.74)μg/L、(10.23±1.67)TU/mL、(2.45±0.29)μg/mL,明显低于非完全缓解患者的(48.17±4.03)μg/L、(16.41±1.50)TU/mL、(3.78±0.67)μg/mL,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清vWF、TM、FDP水平与预后均呈负相关(r=-0.852、-0.863、-0.802,P<0.05)。结论急性白血病患者血清vWF、TM、FDP水平明显升高,化疗后各指标水平降低,与预后具有明显相关性,临床上应予以重视。Objective To study the changes of serum von Willebrand factor(vWF),thromboregulatory protein(TM),and fibrin degradation product(FDP)levels before and after chemotherapy in acute leukemia patients and their correlation with prognosis.Methods A total of 80 patients with acute leukemia admitted to Xi'an Central Hospital from January 2018 to June 2021 were selected as the observation group,including 62 patients of acute myeloid leukemia and 18 patients of acute lymphoblastic leukemia,and 80 healthy people receiving physical examination in the hospital during the same period were selected as the control group.The expression of serum vWF,TM,and FDP levels were compared between the observation group and the control group before chemotherapy,and in the observation group before and after chemotherapy,and among the patients with different curative effects in the observation group.Pearson correlation was used to analyze the correlation between serum vWF,TM,FDP levels and prognosis.Results The serum vWF,TM,and FDP levels in patients with acute myeloid leukemia in the observation group before chemotherapy were(112.18±15.92)μg/L,(29.82±2.98)TU/mL,(6.58±1.37)μg/mL,which were significantly higher than(80.23±12.57)μg/L,(17.03±2.35)TU/mL,(3.84±0.68)μg/mL of patients with acute lymphoblastic leukemia and(28.45±3.28)μg/L,(8.32±1.56)TU/mL,(1.75±0.34)μg/mL of the control group;the levels in patients with acute lymphoblastic leukemia were significantly higher than those in the control group;the differences were statistically significant(P<0.05).After one cycle of chemotherapy,the serum vWF,TM,and FDP levels in observation group were(41.23±3.29)μg/L,(13.03±1.48)TU/mL,and(3.02±0.56)μg/mL,which were significantly lower than(92.18±16.07)μg/L,(25.71±2.97)TU/mL,(5.49±1.25)μg/mL before chemotherapy(P<0.05).In the observation group,25 patients had complete remission and 55 patients had incomplete remission after chemotherapy;the serum serum vWF,TM,and FDP levels in patients with complete remission were(34.23±3.74)μg/

关 键 词：急性白血病 化疗 血管性血友病因子 血栓调节蛋白 纤维蛋白降解产物 预后 相关性 

分 类 号：R733.71[医药卫生—肿瘤]