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目的 观察急性白血病 (AL)患者止、凝血分子标志物的变化以探索其在AL诊断、治疗及预后判断中的意义。方法 用ELISA法检测 82例AL患者血浆组织因子 (TF)、组织因子途径抑制物(TFPI)、凝血酶 抗凝血酶复合物 (TAT)、尿激酶型纤溶酶原激活物 (u PA)、尿激酶型纤溶酶原激活物受体 (u PAR)、纤溶酶 抗纤溶酶复合物 (PAP)。结果 治疗前 ,AL患者TF、TAT、u PA、u PAR显著增高。急性髓系白血病 (AML)患者TFPI、PAP值异常增高。治疗后 ,TF、TAT在AML患者中维持高水平 ;u PA、u PAR在未缓解者持续增高 ;出血严重者PAP、u PA显著升高。结论 不同类型AL患者的止凝血功能异常存在差异 ,可随病情好转逐渐改善。TF、TAT、PAP有助于弥散性血管内凝血防治 ;u PA、u PAR可作为部分AML预后判断的指标。严重出血者需联合应用抗纤溶药。应注意对AML患者治疗后高凝状态的防治
Objective To observe the changes of coagulation molecular markers in patients with acute leukemia (AL) and explore its significance in the diagnosis, treatment and prognosis of AL. Methods Plasma tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin antithrombin complex (TAT) and urokinase-type plasminogen activator (u PA) were detected by ELISA in 82 AL patients. , urokinase-type plasminogen activator receptor (u PAR), plasmin antiplasmin complex (PAP). Results Before treatment, ALT, TF, TAT, u PA and u PAR were significantly increased in AL patients. The abnormal increase of TFPI and PAP in acute myeloid leukemia (AML) patients. After treatment, TF and TAT maintained a high level in AML patients; u PA, u PAR continued to increase in patients without remission; PAP, u PA increased significantly in patients with severe bleeding. Conclusion There are differences in anticoagulation abnormalities in different types of AL patients, which can be gradually improved as the condition improves. TF, TAT, and PAP may contribute to the prevention and treatment of disseminated intravascular coagulation; u PA and u PAR may serve as indicators of prognosis of some AML. In severe bleeding, antifibrinolytic drugs should be used in combination. Attention should be paid to the prevention and treatment of hypercoagulable state in patients with AML after treatment