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目的探讨急性白血病并发弥散性血管内凝血(DIC)前的相关因素,以便早期诊断和积极预防DIC的发生。方法回顾性分析383例急性白血病患者的临床资料,其中确诊并发DIC46例,将确诊DIC前3~5d可能相关的17个因素与未发生DIC患者比较。结果外周血白细胞计数、M3在两组中所在比例差异显著(P<0.01),D二聚体含量、血浆组织因子、凝血酶抗凝血酶复合物、纤溶酶抗纤溶酶复合物、凝血酶原时间、活化部分凝血活酶时间6个因素两组间有显著差异(P<0.05)。血红蛋白、血小板、血脂、血糖、肌酐、血清乳酸脱氢酶及年龄、性别和体温等因素两组间无显著性差异。结论对白细胞计数升高及D二聚体、血浆组织因子、凝血酶抗凝血酶复合物、纤溶酶抗纤溶酶复合物水平高,凝血酶原时间、活化部分凝血活酶时间缩短以及急性早幼粒细胞白血病等(M3)患者应注意弥散性血管内凝血的发生。
Objective To investigate the related factors of acute leukemia before disseminated intravascular coagulation (DIC) in order to diagnose and positively prevent the occurrence of DIC. Methods The clinical data of 383 acute leukemia patients were retrospectively analyzed. Among them, 46 cases were diagnosed as complicated with DIC, and 17 possible factors related to the 3 ~ 5 days before DIC were compared with those without DIC. Results There were significant differences in the ratio of M3 between the two groups (P <0.01), D-dimer, plasma tissue factor, thrombin antithrombin complex, plasmin anti-plasmin complex, Prothrombin time, activated partial thromboplastin time 6 factors were significantly different between the two groups (P <0.05). Hemoglobin, platelets, blood lipids, blood glucose, creatinine, serum lactate dehydrogenase and age, gender and body temperature and other factors between the two groups no significant difference. Conclusions Elevated white blood cell count and D-dimer, plasma tissue factor, thrombin antithrombin complex, high plasmin anti-plasmin complex level, prothrombin time, partial thromboplastin time shortening, and Patients with acute promyelocytic leukemia (M3) should pay attention to the occurrence of disseminated intravascular coagulation.