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目的 探讨急性白血病 (AL)的纤维蛋白溶解 (纤溶 )变化。方法 临床分析 41例AL患者的出血表现及实验检测血小板计数 (BPC)、纤维蛋白 (原 )降解产物 (FDP)、D 二聚体 (D D)、纤溶酶原活性 (PL∶A)、α2 纤溶酶抑制物活性 (α2 PI∶A)、组织型纤溶酶原激活物活性 (t PA∶A)、纤溶酶原激活物抑制物活性 (PAI∶A)。结果 32 %有出血 ,以皮肤粘膜为主 ,部分为内脏或颅内出血。BPC明显减少 ,FDP阳性率为 2 9% ,D D、t PA∶A和PAI∶A明显高于正常 ;D D发病期明显高于完全缓解(CR)期 ;α2 PI∶A在急性早幼粒细胞白血病 (APL)明显低于对照组 ,出血组低于不出血组。PL∶A无明显改变。结论 AL的纤溶异常以继发性纤溶亢进为主 ,是引起AL出血的主要原因之一。CR后纤溶仍处激活状态
Objective To investigate the changes of fibrinolytic (fibrinolysis) in acute leukemia (AL). Methods The clinical manifestation of hemorrhage in 41 patients with AL and the detection of platelet count (BPC), fibrinogen (FDP), D dimer (DD), plasminogen activity (PL: A) Plasmin inhibitor activity (α2 PI: A), tissue-type plasminogen activator activity (t PA: A), plasminogen activator inhibitor activity (PAI: A). Results 32% had bleeding to the skin and mucous membranes, part of the visceral or intracranial hemorrhage. BPC was significantly decreased, the positive rate of FDP was 29%, the levels of DD, t PA:A and PAI:A were significantly higher than those of normal; the incidence of DD was significantly higher than that of complete remission (CR); α2 PI: A was higher in acute promyelocytic Leukemia (APL) was significantly lower than the control group, bleeding group was lower than non-bleeding group. PL: A no significant change. Conclusions The fibrinolytic abnormality of AL is mainly secondary fibrinolysis, which is one of the main causes of AL hemorrhage. After fibrinolysis is still activated state