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目的 探讨急性白血病 (AL)患者的止血功能及其与出血症状及预后的关系。方法 采用ELISA或发色底物法对 93例AL患者血浆凝血、抗凝和纤溶指标进行了检测。结果 治疗前血浆P 选择素、可溶性纤维蛋白单体复合物 (SFMC)、凝血酶调节蛋白 (TM)、组织型纤溶酶原激活剂、D 二聚体(D D)水平显著升高 ;蛋白C抗原 (PC∶Ag)、纤溶酶原活性 (PLG)、α2 抗纤溶酶 (α2 PI)、纤溶酶原激活剂抑制物 (PAI)水平降低 ;纤维蛋白原 (Fg)、蛋白C活性 (PC∶A)、蛋白S(PS)与正常对照组相比差异无显著性。缓解后除PC∶A和PC∶Ag仍增高外 ,余均恢复正常。血小板计数、Fg、SFMC、PLG、α2 PI和D D与出血程度有关。TM升高、发病时PS降低及PAI升高者预后较差。结论 AL发病过程中存在血小板活化以及凝血、抗凝、纤溶系统的激活 ,并随病情的好转而逐渐改善。部分指标对衡量出血程度和患者预后有指导意义
Objective To investigate the hemostatic function of patients with acute leukemia (AL) and its relationship with hemorrhagic symptoms and prognosis. Methods The coagulation, anticoagulation and fibrinolysis indexes of 93 AL patients were detected by ELISA or chromogenic substrate method. Results The levels of plasma P-selectin, soluble fibrin monomer complex (SFMC), thrombin regulatory protein (TM), tissue-type plasminogen activator and D dimer were significantly increased before treatment. Protein C Antigen (PC: Ag), plasminogen activity (PLG), α2 anti-plasmin (α2 PI) and plasminogen activator inhibitor (PAI) decreased; Fg, (PC: A), protein S (PS) compared with the normal control group no significant difference. After remission in addition to PC: A and PC: Ag is still high, I have returned to normal. Platelet count, Fg, SFMC, PLG, α2 PI and D D were related to the degree of bleeding. TM increased, PS decreased incidence and PAI increased poor prognosis. Conclusion Platelet activation and activation of coagulation, anticoagulation and fibrinolytic system exist during the pathogenesis of AL, and gradually improve with the improvement of the disease. Some indicators of the degree of bleeding and prognosis of patients with guidance