急性粒细胞白血病病人TATvWFDD的检测及临床意义.docVIP

急性白血病病人TAT、vWF、DD的及临床意义目的检测不同类型急性白血病病人不同发展阶段凝血酶-抗凝血酶Ⅲ复合物（thrombin antithrombin Ⅲ complex, TAT）、血管性血友病因子（von willebrand factor, WF）、D-二聚体（d-dimer, DD）含量的变化，以探讨这些活性物质急性白血病。用ELISA测定了急性白血病病人和正常人血浆TAT、WF、DD的含量，并对急性白血病病人进行了不同出血程度、不同阶段的动态监测急性白血病病人初诊时血浆TAT、WF、DD含量明显升高急性白血病病人治疗中WF含量较治疗前显著升高一个疗程的治疗后，达到完全缓解时，TAT在急性白血病血浆中仍维持较高水平急性早幼粒细胞白血病病人血浆TAT、WF、DD含量在治疗前均高于其他类型急性白血病病人，应用维甲酸（ATRA）治疗第7天后与治疗前比较TAT、WF、DD含量降低DD水平在治疗第21天已降至正常水平，而TAT在达完全缓解时仍未降至正常。急性白血病治疗前体内存在凝血，纤溶系统的同时激活及内皮细胞的损伤不同出血程度的病人的出凝血机制不同，重度出血病人以体内纤溶系统的激活为主，轻度出血的病人体内以高凝为主，因此治疗急性白血病病人化疗药物的应用在内皮细胞的损伤上起关键作用，治疗上应予以重视急性白血病 急性白血病凝血酶-抗凝血酶Ⅲ复合物血管性血友病因子D-二聚体 Objective To measure the levels of plasma thrombin antithrombin Ⅲ complex(TAT), von willebrand factor(VWF), D-dimer(DD) in different phrases of patients with acute myeloid leukemia, and to explore their significance in the diagnosis and clinical therapy of Acute myeloid leukemia Methods acute myeloid leukemia patients and health adult were selected into the study. The levels of plasma thrombin antithrombin Ⅲ complex, von willebrand factor and d-dimer were measured by enzyme linked immunosorbent assay and blood analysis mechine. Results Compared with normal control group, plasma levels of TAT, vWF and DD were elevated before treatment in acute myeloid leukemia patients; During the treatment , plasma levels of vWF were much higher in patients than that before treatment; After complete remission, TAT remained high in Acute myeloid Leukemia; Compared with other AL patients, plasma levels of TAT, VWF and DD increased in APL patients before treatment. After treating the APL patients by ATRA for 7 days, we find TAT, vWF and DD content were lower than before, the difference is significant, The plasma levels of DD decreased into normal levels after treatment for 21 days, but the levels of TAT was not recovery. Conclusions Activation of the injury of vascular endothelium, coagulation and fibrinolysis existed in Acute myeloid Leukemia patients, Patient with severe hemorrhage should be trea