小剂量肝素和低分子肝素治疗恶性血液病血栓前状态的临床研究  

Clinical study on low-dose heparin and low-molecular mass heparin in treating pre-thrombosis in patients with hematologic malignancies

作　　者：孔荣[1] 

机构地区：[1]南京医科大学第三附属医院血液科,江苏仪征211900

出　　处：《临床荟萃》2004年第4期184-186,共3页Clinical Focus

基　　金：南京医科大学科技发展基金资助项目 (NY2 0 0 0 51 )

摘　　要：目的　探讨D 二聚体 (D dimer,D D)在恶性血液病患者中的临床意义 ,以及使用小剂量肝素和低分子肝素后的变化。方法　正常对照 2 0例。恶性血液病 4 5例 ,分为 3组 :①单纯化疗组 (15例 ) ;②小剂量肝素组 (15例 ) ;③低分子肝素组 (15例 )。采用酶联免疫吸附测定 (ELISA)双抗夹心法对 4 5例恶性血液病进行了D D测定。结果　恶性血液病组D D较对照组明显增高 ,差异具有统计学意义 (P <0 .0 1) ,使用小剂量肝素和低分子肝素后D D含量较初诊时明显降低 (P <0 .0 5 ) ,且低分子肝素组较小剂量肝素组降低更为明显 (P <0 .0 5 )。结论　恶性血液病患者D D含量可早期发现血栓前状态 ,低分子肝素较小剂量肝素具有更明显降低D D含量的作用。低分子肝素改善血栓前状态有效、安全。Objective To observe the effects of D-dimer(D-D) in patients with hematologic malignancies, and changes of using the low-dose of heparin and low-molecular mass heparin. Methods One healthy control group consisted of 20 cases.The hemotogogic malignancy group consisted of 45 cases,and were divided into three groups:①Simple chemotherapy group(15 cases);②Low-dose heparin group(15 cases);③Low-molecular mass group(15 cases).The plasma concentration of D-D was measured by enzyme-linked immunosorbent assay(ELISA) in 45 patients with hematologic malignancies. Results The plasma concentration of D-D was significantly higher in hematologic malignancy group than in the healthy control group(P< 0.01). After chemotherapy, the concentration of D-D was significantly decreased (P< 0.05). The concentration of D-D in the low molecular mass group decreased much more significantly than that of low-dose heparin group(P< 0.05). Conclusion Detection of the concentration of D-D is important in finding pre-thrombotic state, the concentration of D-D in the low molecular mass group decreased much more significantly than that of low-dose heparin group. It proved that the low molecular mass therapy in pre-thrombotic state has a high efficacy and less side reactions.

关 键 词：血液病 肿瘤 血栓形成 肝素 依诺肝素 剂量效应关系 药物 酶联免疫吸附测定 

分 类 号：R733[医药卫生—肿瘤]