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目的:探讨复方黄黛片治疗急性早幼粒细胞白血病(APL)过程中弥漫性血管内凝血(DIC)的临床特征及其对复方黄黛片疗效的影响。方法:回顾性分析109例APL中发生DIC的临床表现、检测指标及治疗效果,利用SPSS 11.5软件统计分析。结果:复方黄黛片治疗APL中DIC发生率为11.8%。DIC以皮肤黏膜出血多见,3个及以上部位出血数占71.11%。D-二聚体、PT、3P、Fbg、APTT、TT检测异常率分别为93.3%、77.8%、76.2%、64.4%、44.4%、37.8%。以肝素为主的综合治疗,DIC的治愈率为95.6%。DIC组、无DIC组的中位CR时间分别为48、43 d(M),U=1.112,P>0.05,DIC组、无DIC组均全部获得CR。结论:复方黄黛片不诱发加重DIC,发生DIC与否对复方黄黛片疗效无影响;D-二聚体是良好的检测指标,早期应用以小剂量肝素为主的综合治疗是纠正DIC的有效方法,可降低相关死亡率。
Objective: To investigate the clinical features of compound intracoronary coagulation (DIC) in the treatment of acute promyelocytic leukemia (APL) and its effect on the curative effect of compound Huangqi tablets. Methods: The clinical manifestations, detection indexes and therapeutic effects of DIC in 109 patients with APL were retrospectively analyzed. Statistical analysis was performed using SPSS 11.5 software. Results: The incidence of DIC in compound Astragalus tablets in the treatment of APL was 11.8%. DIC was more common in skin and mucous membrane bleeding, accounting for 71.11% of bleeding in three or more sites. The detection abnormalities of D-dimer, PT, 3P, Fbg, APTT, and TT were 93.3%, 77.8%, 76.2%, 64.4%, 44.4%, and 37.8%, respectively. With heparin-based comprehensive treatment, the cure rate of DIC was 95.6%. The median time of CR in the DIC group and the non-DIC group was 48 and 43 days (M), respectively, U=1.112, P>0.05. All of the DIC group and non-DIC group received CR. Conclusion: Compound Huangqi Tablets does not induce DIC aggravation, and DIC or not has no effect on the efficacy of Compound Huangqi Tablets; D-dimer is a good detection indicator. Early application of low-dose heparin-based comprehensive treatment is to correct DIC Effective methods can reduce related mortality.