急性白血病患者血浆Hcy、AT-III及vWF的检测及其临床意义

目的:检测急性白血病(acuteleukemia,AL)患者不同发展阶段血浆同型半胱氨酸(homocysteine,Hcy)、抗凝血酶Ⅲ(antithrombinIII)、血管性血友病因子(vonwillebrandfactor,vWF)水平,探讨这些活性物质在AL的诊断、治疗及预后判断中的临床意义。方法:选择初诊AL患者40例,正常对照30例。测定其血浆Hcy、AT-III及vWF水平,并对AL患者进行治疗前、后不同阶段的动态检测。骨髓涂片在显微镜下按常规分类计数200个有核细胞,计算原始加幼稚细胞比例。结果:AL组初诊时血浆vWF含量明显升高,与正常对照组比较有显著性差异(P<0.01)。AL组初诊时血浆AT-III含量明显减低,与正常对照组比较差异有统计学意义(P<0.05)。AL组初诊时血浆Hcy含量明显升高,与正常对照组比较有显著性差异(P<0.01)。经过2-3个疗程的治疗后,达到完全缓解(CR)时,血浆Hcy、AT-Ⅲ及vWF含量恢复正常,与正常对照组比较无显著差异(P>0.05)。经过2-3个疗程的治疗后,未达到缓解包括部分缓解(PR)和未缓解(NR)]时,上述因子与治疗前比较差异无统计学意义(P>0.05);AL初诊患者治疗前血浆vWF及Hcy水平与骨髓原始加幼稚细胞数呈正相关(P<0.001和P<0.01),而AT-Ⅲ水平与骨髓原始加幼稚细胞数呈负相关(P<0.05,r=-0.622)。结论:动态监测AL患者血浆Hcy、AT-III及vWF水平,可作为白血病病情进展、疗效过程及判断预后的重要参考指标。

Effect of modified saidingge puncture in toughing vascular PICC guilded by site - rite V ultrasound on hematolagic tumor patients with low platelet counts

Objective：To stuly the effect of modified saidingge Puncture in vascular PICC guilded by Site - rite V ultrasound on hematolagic tumor Patients with low Platelet counts. Methods：All 72 hematolagic tumor Patients with low Platelet counts were randomly divided into two grouPs,35 cases in exPerimental grouP（modified saidingge Punc-ture in tough vascular PICC on Site - rite V ultrasound - guild）and 37 cases in control grouP（blind Puncture）. Com-Pared the success rate and comPlication rate between the two grouPs. Resulets：The success rate and comPlication rate in exPerimental grouP were 97. 14% and 14. 29% ;The success rate and comPlication rate in control grouP were 78. 38% and 48. 65%（P ﹤ 0. 05）. Conclusion：Modified saidingge Puncture in tough vascular PICC guilded by Site- rite V ultrasound can increase Puncture sucess rate and decrease comPlication rate in hematolagic tumor Patients with low Platelet counts. It can also imProve the Patient＇s aPProval on nurse＇s work.