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目的探讨急性白血病(AL)患者血浆组织因子(TF)及组织因子途径抑制物(TFPI)、D-二聚体(D-D)的含量变化对其病情进展、疗效观察及预后的意义。方法检测44例AL患者初诊时及化疗1个疗程后第7 d血浆TF、TFPI及D-D的水平,并检测20例正常体检者和随访期间8例复发的AL患者血浆TF、TFPI及D-D的水平。所有患者平均随访180 d,观察随访期间病情变化。结果 AL组患者血浆TF、TFPI和D-二聚体水平明显高于正常组;缓解组患者血浆TF、TFPI水平均较初诊时明显下降(P<0.01)且与对照组差异无统计学意义(P>0.05),D-D水平比治疗前明显降低但仍高于正常组(P<0.01);D-D比初诊时明显降低但仍高于对照组(P<0.01)。未缓解组患者治疗后与初诊时比较血浆TF、TFPI水平比较差异无统计学意义(P>0.05)且均明显高于正常对照组(P<0.01);复发时血浆TF、TFPI和D-D水平均明显升高,与初诊相比差异均有统计学意义(P<0.01)。结论动态观察白血病患者血浆TF、TFPI、D-D变化对AL患者判断病情、预测复发、指导治疗有重要意义。
Objective To investigate the changes of plasma Tissue Factor (TF), Tissue Factor (TFPI) and D-D (D-D) in patients with acute leukemia (AL) and to evaluate their clinical significance and prognosis. Methods Plasma levels of TF, TFPI and DD were detected in 44 AL patients at the time of first visit and one day after chemotherapy, and the levels of plasma TF, TFPI and DD were measured in 20 normal controls and 8 relapsed AL patients during the follow-up period . All patients were followed up for an average of 180 days. The changes of the patients during follow-up were observed. Results The levels of plasma TF, TFPI and D-dimer in AL group were significantly higher than those in normal group. The plasma levels of TF and TFPI in remission group were significantly lower than those at initial stage (P <0.01), but not in control group (P <0.05). The level of DD was significantly lower than that before treatment but still higher than that of the normal group (P <0.01). DD was significantly lower than that of the control group (P <0.01). The levels of plasma TF and TFPI in non-remission patients after treatment were significantly higher than those in normal controls (P <0.01), while the levels of TF, TFPI and DD in patients with relapsed The difference was statistically significant (P <0.01). Conclusion Dynamic observation of leukemia patients with plasma TF, TFPI, D-D changes in patients with AL to determine the disease, predict recurrence, guiding the treatment of great significance.