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目的探讨低分子肝素辅助治疗急性早幼粒细胞白血病伴弥散性血管内凝血(DIC)的临床疗效。方法选取濮阳市安阳地区医院2010年1月—2015年1月收治的急性早幼粒细胞白血病伴DIC患者42例,随机分为对照组与观察组,各21例。对照组患者给予常规治疗,观察组患者在对照组治疗基础上给予低分子肝素辅助治疗,比较两组临床疗效和病死率及血小板(PLT)、D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)变化情况。结果观察组患者总有效率高于对照组,病死率低于对照组。治疗前两组患者凝血指标比较,差异无统计学意义(P>0.05);治疗后观察组患者PLT、D-二聚体、PT、APTT、FIB水平低于对照组,差异有统计学意义(P<0.05)。结论低分子肝素辅助治疗急性早幼粒细胞白血病伴DIC的疗效确切,可有效改善患者症状,提高患者存活率。
Objective To investigate the clinical efficacy of low molecular weight heparin adjuvant in the treatment of acute promyelocytic leukemia with disseminated intravascular coagulation (DIC). Methods Forty-two acute promyelocytic leukemia patients with DIC admitted from Anyang District Hospital of Puyang from January 2010 to January 2015 were randomly divided into control group and observation group, 21 cases in each group. The patients in the control group were given routine treatment. The patients in the observation group were given adjuvant LMWH on the basis of the control group. The clinical efficacy, mortality and platelet (PLT), D-dimer, prothrombin time (PT) , Activated partial thromboplastin time (APTT), fibrinogen (FIB) changes. Results The total effective rate of observation group was higher than that of control group, and the mortality was lower than that of control group. There was no significant difference in coagulation index between the two groups before treatment (P> 0.05). After treatment, the levels of PLT, D-dimer, PT, APTT and FIB in the observation group were lower than those in the control group P <0.05). Conclusion Low molecular weight heparin adjuvant treatment of acute promyelocytic leukemia with DIC is effective and can effectively improve the symptoms and improve the survival rate of patients.