老年和青年急性心肌梗死临床特点和心理分析

目的分析103例青年和老年急性心肌梗死(AMI)患者的临床特点和心理状态.方法将103例AMI患者按年龄分为老年组和青年组,并对二组的临床特点和心理状态进行分析.结果①青年组AMI均为男性,吸烟占95.5%,饮酒占90.9%,均明显高于老年组(P＜0.01).老年组AMI有高血压病占48.1%,高脂血症占60.5%,糖尿病占34.6%,均明显高于青年组(P＜0.05).②青年组AMI患者以焦虑为主,占59.1%,与老年组比较差异有统计学意义,老年组患者以抑郁为主,占45.7%,二组比较差异有统计学意义(P＜0.05).③青年组有典型心绞痛19例,占86.3%,与老年组比较差异有统计学意义.④二组比较,老年组病死率高于青年组(P＜0.05).结论男性、大量吸烟、大量饮酒是青年AMI的主要危险因素;而高血压病、糖尿病等并发症是老年AMI的主要危险因素.青年AMI以焦虑为主,症状典型;而老年AMI以抑郁为主,症状不典型,并发症多,病死率高.     

老年人与青年人自发性气胸临床对比分析

目的 通过对比分析两种不同年龄组患者气胸的临床特点,提高对老年人气胸的认识.方法 对≥60岁老年人气胸58例(老年组)和≤40岁青年人气胸121例(青年组)的病因、诱因、临床表现、气胸类型、治疗方法、并发症、误诊率、病死率进行对比分析.结果 病因构成:老年组继发性气胸占100%,高于青年组29.8%,P＜0.01.诱因:老年组有诱因者(19.0%)低于青年组(42.1%),P＜0.01.临床表现:胸痛症状老年组(41.4%)低于青年组(72.7%)(P＜0.01).气急症状老年组(91.4%)高于青年组(20.7%)(P＜0.01).咳嗽症状老年组(96.6%)与青年组(81.8%)相比差异无统计学意义(P＞0.01).但老年组的咳嗽同时有咯痰,而青年组的咳嗽症状则以刺激性干咳为主.气胸类型与治疗:老年组张力型气胸(21例)高于青年组(0例)(P＜0.01).老年组需给予胸腔闭式引流术治疗的病例(81.0%)高于青年组(43.0%)(P＜0.01).并发症:老年组(44.8%)高于青年组(9.1%)(P＜0.01).误诊率:老年组(25.9%)高于青年组(2.5%),P＜0.01.病死率:老年组(6例)高于青年组(0例),P＜0.01.结论 老年人气胸具有原发病多为慢性阻塞性肺疾病、胸痛症状较少、呼吸困难明显、并发症多、易误诊、病死率较高的临床特点.     

老老年与中青年高血压病人血压水平及昼夜节律差异的研究

目的 观察老老年与中青年高血压病人血压水平及昼夜节律的差异,并探讨其临床意义及治疗.方法 选择我院2009年9月-2011年8月在内科病房住院及门诊就诊的病人,按年龄分为老老年组(61例)与中青年组(42例),两组均作诊室血压测量和24 h动态血压监测,比较两组的血压水平和昼夜节律.结果 中青年组诊室舒张压明显高于老老年组[(98.7±11.0)mmHg比(78.1±11.9)mmHg,P＜0.01],老老年组中单纯收缩期高血压者明显多于中青年组[80.3%比11.9%,P＜0.01].动态血压监测结果显示,中青年组24 h、白昼、夜间平均舒张压均高于老老年组(P＜0.05或P＜0.01),而24 h、白昼、夜间平均脉压低于老老年组(P＜0.01),老老年组夜间收缩压明显高于中青年组(P＜0.01),非杓型血压形态明显高于中青年组(85.2%比40.5%,P＜0.01).结论 老老年组高血压病病人单纯收缩期高血压者明显多于中青年组,舒张压低于中青年组,脉压高于中青年组,非杓型血压形态发生率高于中青年组.老老年高血压病人的降压治疗,应选择长效药物,平稳降压,并根据动态血压形态调整服药时间.     

黏附分子CD56、CD44、CD54、CD11a在急性髓系白血病骨髓中的表达及意义

目的:探讨黏附分子CD56、CD44、CD54、CD11a在急性髓系白血病(AML)骨髓中的表达情况及临床意义。方法:流式细胞仪检测57例AML患者和20例正常对照者骨髓单个核细胞表面CD56、CD44、CD54、CD11a的表达水平,分析其与AML患者白细胞计数、白细胞淤滞及早期病死率的关系。结果:1CD56仅在AML组表达(AML组表达率为35.1%,正常对照组0,P0.05),其在AML高白细胞(HAML)组的表达率(53.3%)高于AML非高白细胞(NHAML)组(28.6%),白细胞淤滞组(62.5%)高于无白细胞淤滞组(28.9%)(P0.05);2AML患者骨髓单个核细胞表面CD44的平均荧光强度在HAML组显著高于NHAML组(P0.05),其表达与AML患者外周血白细胞计数呈正相关(r=0.446,P0.01)。CD56、CD54、CD11a在HAML组与NHAML组、无白细胞淤滞组与白细胞淤滞组的平均荧光强度均差异无统计学意义(P0.05)。3AML患者中HAML组、白细胞淤滞组患者的早期病死率(33.3%、25.0%)分别明显高于NHAML组、无白细胞淤滞组(0、0)。结论:CD56在HAML患者和白细胞淤滞患者有更高的表达率,有可能是AML患者预后不良的因素之一;CD44在AML患者骨髓中的表达水平与外周血白细胞计数呈正相关,可能参与HAML的发生。CD54、CD11a与HAML及白细胞淤滞的关系不十分密切。     

老年及中青年轻型缺血性脑卒中临床特点及预后对比研究

目的对比老年及中青年轻型缺血性脑卒中患者不同临床特点及预后。方法选择轻型缺血性脑卒中患者231例,根据年龄分为老年组103例,中青年组128例。对2组资料对比分析。结果老年组年龄、心房颤动比例明显高于中青年组,吸烟、高同型半胱氨酸血症比例明显低于中青年组(P0.05,P0.01)。老年组多发部位梗死病灶和弥散加权成像阴性比例明显高于中青年组,基底节区梗死比例明显低于中青年组(P0.05,P0.01)。TOAST病因分型中,老年组以大动脉粥样硬化型为主,中青年组以小动脉闭塞型为主。老年组不明原因型比例明显低于中青年组(5.8%vs 16.4%,P0.05),大动脉粥样硬化型比例明显高于中青年组(43.7%vs 21.9%,P0.01)。老年组早期神经功能恶化和预后不良比例明显高于中青年组(32.0%vs 20.3%,28.2%vs 16.4%,P0.05)。结论老年轻型缺血性脑卒中患者TOAST分型中大动脉粥样硬化型所占比例大,发生神经功能恶化的比例高,预后较差。     

成人急性淋巴细胞白血病免疫表型特征及临床意义

目的:探讨成人急性淋巴细胞白血病(ALL)细胞免疫表型特点及其对疗效的影响。方法:46例成人ALL初治患者,采用流式细胞术方法分析患者的免疫表型,然后给予标准诱导缓解方案(VDCLP方案)化疗,并观察其疗效。分析比较ALL伴髓系相关抗原(CD11b、CD13、CD14、CD15、CD33、CD117、cMPO)阳性患者与阴性患者之间的完全缓解(CR)率,HLA-DR表达情况及其与化疗后CR的关系。结果:46例ALL患者中,共有28例表达髓系相关抗原。伴髓系抗原表达阳性患者(My+ALL)CR率为78.6%,与伴髓系抗原表达阴性患者(My-ALL)CR率(83.3%)比较差异无统计学意义(P0.05)。ALL患者HLA-DR+表达率为65.2%,HLADR+和HLA-DR-ALL患者CR率比较差异有统计学意义(70%∶100%,P0.05)。结论:ALL患者无论有无髓系抗原的表达其疗效无显著差异,但HLA-DR表达则明显降低化疗后CR率。     

急性髓细胞白血病免疫表型分析

目的：分析成人初治急性髓细胞白血病（AML）髓系抗原、CD34及Pgp表达特点及其与预后的关系。方法：采用流式细胞仪免疫荧光标记法检测65例初治成人AML的免疫表型。结果（1）髓系抗原阳性率依次为CD33＞CD15＞CD13＞CD14,CD33阳性率高达98．46％。CD14在M5、M6表达率较高;（2）CD34及HLA－DR阳性表达率以M1、M5较高,M3最低;（3）P－糖蛋白（PG)阳性率58．33％,Pgp阳性AML的CR率28．57％,明显低于Pgp阴性的CR率（63．63％,P＜0．005）。结论AML的免疫表型检测髓系单抗可选择CD33、CD15和（或）CD14。CD34和HLA－DR低表达为M3的特征。Pgp表达与CR率有密切的关系。     

髓系抗原、P-糖蛋白和CD34抗原在急性淋巴细胞白血病中的表达及其意义

目的　探讨急性淋巴细胞白血病 (ALL)的髓系抗原、P 糖蛋白 (P gp)和CD3 4 表达特点及其与预后的关系。方法　采用间接免疫荧光法标记流式细胞仪 (FCM )检测 84例初治ALL患者的免疫表型。结果　ALL髓系抗原阳性率为 17.8% ,其中CD13 阳性最常见。CD3 4 表达阳性率为45 .3 % ,与髓系抗原表达和治疗缓解率无显著相关性。髓系抗原阳性组病例 (My ALL)肝脾肿大明显 ,白细胞总数增高显著 ,完全缓解 (CR)率明显低于阴性组病例 (P <0 .0 1)。P gp阳性表达率为 3 2 .1% ,P gp表达阳性与My ALL化疗效果有相关性。结论　My ALL细胞对于常规诱导缓解方案不敏感 ,选择兼顾ALL AML的方案可提高治疗效果。P gp高度表达与低CR率有密切关系     

急性髓系白血病患者外周血表达髓系抑制细胞的临床研究

目的:检测急性髓系白血病(AML)患者不同阶段外周血髓系抑制细胞(MDSCs)的表达量,并探讨其与肿瘤相关巨噬细胞(TAM,CD206+)、调节性T细胞(Tregs,CD4+CD25+)的关系。方法:采用流式细胞术检测AML患者30例初诊未治及完全缓解(CR)后外周血表型为CD33+/CD11b+/HLA-DR-/lin-的MDSCs比例,同时检测TAM及Tregs表达水平,并以健康体检者30例作为对照,检测以上指标的变化。结果:1AML患者初诊未治期外周血MDSCs高度表达,显著高于对照者[(5.83±1.66)%∶(0.63±0.31)%,P0.05],经化疗达CR后其数值显著下降,均值为(1.03±0.20)%,CR前、后比较差异有统计学意义(P=0.03);2AML患者初诊未治期外周血表达CD206+的TAM高于对照者[(5.32±1.55)%∶(1.69±0.44)%,P=0.15],经治疗达CR后明显回落;3AML患者初诊未治期外周血表达CD4+CD25+的Tregs明显高于治疗后及对照者[(6.75±0.68)%∶(2.21±0.45)%∶(1.98±0.65)%),P0.01]。结论:MDSCs在AML不同阶段呈规律性表达,与TAM及Tregs表达趋势一致,提示在AML发生、发展过程中MDSCs可能参与了白血病细胞的免疫耐受及肿瘤逃逸机制。     

中青年急性心肌梗死患者临床特征分析

目的分析中青年急性心肌梗死患者(AMI)临床特征。方法选取2010—2013年南阳市第二人民医院收治的AMI患者407例,根据年龄分为中青年组91例(60岁)和老年组316例(≥60岁),比较两组患者一般资料、心电图表现、冠状动脉造影及超声心动图检查结果、心功能Killip分级。结果两组患者性别比较,差异无统计学意义(P0.05);老年组患者糖尿病、高血压发生率及有起病诱因者所占比例高于中青年组,首发表现为呼吸系统症状、肩背部疼痛、中枢神经系统症状、胃肠道症状及其他症状者所占比例高于中青年组,首发表现为胸痛、胸闷者所占比例低于中青年组,上消化道出血、休克、心力衰竭及心律失常发生率高于中青年组,急性脑血管意外发生率低于中青年组(P0.05)。两组患者心房梗死、后壁梗死及前间壁梗死发生率比较,差异无统计学意义(P0.05);老年组患者高侧壁梗死、下壁梗死及≥2个部位梗死、非ST段抬高发生率高于中青年组,右心室梗死、广泛前壁梗死发生率低于中青年组,差异均有统计学意义(P0.05)。两组患者左主干病变发生率比较,差异无统计学意义(P0.05);老年组患者前降支病变、回旋支病变、右冠状动脉病变及≥2支病变发生率高于中青年组,血管正常率低于中青年组(P0.05)。两组患者左心房内径、左心室舒张期末径及室间隔厚度比较,差异无统计学意义(P0.05);老年组患者左心室射血分数、左房室瓣口舒张早期峰值血流速度(E值)低于中青年组,左房室瓣口舒张晚期峰值血流速度(A值)高于中青年组,心功能Killip分级差于中青年组(P0.05)。结论中青年AMI患者多存在起病诱因、首发表现较典型、冠状动脉病变严重程度较轻、心功能较好,应积极予以治疗以改善其预后。     

老年急性白血病患者50例临床特征分析

目的:探讨老年急性白血病(AL)的临床特点,以利于有效治疗。方法:回顾分析50例60岁以上的老年AL患者的临床资料,包括年龄分布、基础疾病、主要症状、临床特征、骨髓(BM)象、染色体、免疫分型、化疗的完全缓解(CR)率、BM抑制程度、病程及病死率。并与同期住院的66例中青年患者进行比较。结果:老年AL发病率占同期成人AL的27%(50/185)。AML的CR率35.7%(15/42),ALL的CR率33%(2/6)。其基础疾病的发病率86%、MDS转化为AML占20%、病程(35.5±16.5)d、BM抑制时间(18.5±6.5)d、病死率20%、染色体核型为-5、-7、+8、+21,以上均高于同期的中青年组(均为P<0.01)。结论:老年AL患者并存基础疾病和染色体核型异常是其病死率高的主要原因,目前尚无早期诊断和有效治疗老年AL的满意策略,呼吁重视此方面的研究。     

Acute myelogenous leukaemia in the elderly: retrospective study of 235 consecutive patients

A retrospective analysis was performed on 235 elderly acute myelogenous leukaemia (AML) patients aged 60 years or more, consecutively admitted to a single haematological department during a 10-year period from 1980 to 1989. 46% of patients received only conventional induction chemotherapy. The rate of inclusion in EORTC cooperative clinical trials was significantly lower than for younger patients despite specific protocols proposed for the elderly since 1983, thus confirming the important selection bias of most published series on elderly AML patients. Compared with treatment results in patients <60 years. complete remission (CR) rate was lower (33·3% v 65·4%, P <0·0001), with a marked drop in patients older than 70, and induction death rate was higher (21·3% v 12·5%, P = 0·04). Intrinsic characteristics of leukaemic cells, especially expression of the MDR1 gene, in vitro growth of the leukaemic clonogenic cells and sensitivity to daunorubicin+cytosine arabinoside, did not differ according to age, except that there was a higher incidence of previous myelodysplastic syndromes and a lower incidence of good prognostic cytogenetics in the elderly patients. Thus, treatment failure in elderly AML patients appears to be mainly due to host-related factors (especially performance status and age < or ±70 years), and to inadequate treatments. Some elderly patients may have been undertreated because of the planned anthracycline dose reduction, resulting in a higher rate of 'resistant'AML, i.e. patients surviving the induction period without entering into CR, than in younger patients (45·4% v 22·1%, P <0·0001). 11 patients (4·7%) with untreated or 'resistant'AML survived more than 1 year, while receiving only supportive care. These slowly progressive AML patients were characterized by a good performance status, and lower circulating blast cells and bone marrow blast counts.     

Dismal prognostic value of monosomal karyotype in elderly patients with acute myeloid leukemia: a GOELAMS study of 186 patients with unfavorable cytogenetic abnormalities

The prognosis of acute myeloid leukemia (AML) is very poor in elderly patients, especially in those classically defined as having unfavorable cytogenetics. The recent monosomal karyotype (MK) entity, defined as 2 or more autosomal monosomies or combination of 1 monosomy with structural abnormalities, has been reported to be associated with a worse outcome than the traditional complex karyotype (CK). In this retrospective study of 186 AML patients older than 60 years, the prognostic influence of MK was used to further stratify elderly patients with unfavorable cytogenetics. CK was observed in 129 patients (69%), and 110 exhibited abnormalities according to the definition of MK (59%). MK(+) patients had a complete response rate significantly lower than MK(-) patients: 37% vs 64% (P = .0008), and their 2-year overall survival was also decreased at 7% vs 22% (P < .0001). In multivariate analysis, MK appeared as the major independent prognostic factor related to complete remission achievement (odds ratio = 2.3; 95% confidence interval, 1-5.4, P = .05) and survival (hazard ratio = 1.7; 95% confidence interval, 1.1-2.5, P = .008). In the subgroup of 129 CK(+) patients, survival was dramatically decreased for MK(+) patients (8% vs 28% at P = .03). These results demonstrate that MK is a major independent factor of very poor prognosis in elderly AML.     

Characteristics of acute myeloid leukemia with myelodysplasia‐related changes: A retrospective analysis in a cohort of Chinese patients

We retrospectively analyzed 449 patients with AML under the WHO classification of AML 2008 and probed implications of this classification in diagnosis and treatment of acute myeloid leukemia with myelodysplasia‐related changes (AML‐MRC) among them. The clinical presentations, biological features, treatments, and prognosis of patients diagnosed with AML‐MRC were analyzed and compared with those of AML not otherwise specified (AML‐NOS). In all patients, 115 (25.6%) were diagnosed as AML‐MRC including 64 males and 51 females with median onset age of 48 years (range from 17 to 78). Their complete remission (CR) rate was 60.9% and relapse rate was 57.1%. The observed median overall survival (OS) and disease‐free survival (DFS) were 10 and 5 months, respectively, which was significantly shorter than those of AML‐NOS patients (P < 0.05). The prognosis of AML‐MRC patients with myelodysplastic syndrome (MDS)‐related cytogenetics sole was similar to those with history of MDS or myelodysplastic/myeloproliferative neoplasm (MDS/MPN). Patients with MDS‐related cytogenetic abnormalities and/or history of MDS or MDS/MPN predisposed significantly shortened CR, OS, and DFS than AML‐MRC patients with only multilineage dysplasia (MLD) and AML‐NOS patients (P < 0.05). Multivariate analysis showed that age, cytogenetics, and history of MDS or MDS/MPN were independent prognostic factors. Patient diagnosed as AML‐MRC presented distinctive clinical and biological features. Presence of MLD does not change the prognosis. Am. J. Hematol. 89:874–881, 2014. © 2014 Wiley Periodicals, Inc.     

Differences in prognostic factors and outcomes in African Americans and whites with acute myeloid leukemia

Whites have a more favorable prognosis than African Americans for a number of cancers. The relationship between race and outcome is less clear in acute myeloid leukemia (AML). Using data from 7 Cancer and Leukemia Group B studies initiated from 1985 to 1997, we conducted a retrospective cross-sectional analysis of 2570 patients (270 African American and 2300 white) with de novo AML who received induction chemotherapy. African Americans were younger than whites (48 versus 54 years, P <.001). African Americans also had different cytogenetic risk group distributions than whites (P <.001): they were more commonly classified in the favorable (23% versus 14%) and unfavorable (31% versus 23%) groups, and less commonly classified in the intermediate group (47% versus 63%). African American men had a lower complete remission (CR) rate (54%, compared with 64% for white men, 65% for white women, and 70% for African American women, P =.001) and a worse overall survival compared with all other patients (P =.004), when known risk factors are taken into account. African Americans and whites with AML differ with respect to important prognostic factors. African American men have worse CR rates and overall survival than whites and African American women, and should be considered a poor-risk group.     

Time from diagnosis to treatment initiation predicts survival in younger, but not older, acute myeloid leukemia patients

Acute myeloid leukemia (AML) is considered an oncologic emergency. Delaying induction chemotherapy until molecular testing results return, may benefit some patients but harm others. We examined the effect of time from AML diagnosis to treatment (TDT) on complete remission (CR) and overall survival (OS), using patient characteristics available at diagnosis. Regression models were applied to older (> or = 60 years) and younger (< 60 years) adults, controlling for age, baseline white blood cell count, secondary AML (sAML), and performance status. Median patient age was 60 years (range, 17-87 years), TDT 4 days (range, 1-78 days), and 45% had sAML. Cytogenetic risk distribution was: favorable, 8%; intermediate, 66%; unfavorable, 26%. CR rate was 67% and median OS was 68 weeks in patients younger than 60 years; 55% and 33 weeks in older patients, respectively. In univariate and multivariate analyses, longer TDT was associated with worse CR and OS in younger (univariate: P < .001 in both; multivariate: P < .001 and P = .001, respectively), but not older patients (univariate: P = .45, P = .19; multivariate: P = .63, P = .30, respectively). Results did not change with inclusion of cytogenetic data or in risk group subsets. AML therapy should be initiated immediately in younger patients. Delaying treatment does not seem harmful in older patients, allowing individualized approaches.     

Gastroesophageal reflux: the features in elderly patients

INTRODUCTlONWiththeintroduction0fintraesophageal24-hpH-m0nitoringinclinicalpractice,itisnowpossibletoidentifypatternsofgastroesophagealreflux(GER)inthehealthypeopleandpatientsandtoassesstheeffectofH2blockersandH oc adenosinetriphosphatase(ATPase)inhibitorsonGERdiseasesL1Ai7I.ItisincreasinglyrecognizedthatsymptomaticGERmayoccurinthepatients0fallages.However,littleinformationisavailableonsymptomaticGERpatternsintheelderly.Recently,Moldetal,investigatedGERdisease(GERD)inpatientsag…     

国际工作组免疫性血小板减少新分期标准与糖皮质激素疗效的关系

目的 探讨免疫性血小板减少(ITP)在新的诊断标准与分期下的规范化一线治疗方案.方法 对山东大学齐鲁医院2004年3月至2009年11月间使用大剂量地塞米松冲击治疗或泼尼松方案治疗的178例成人ITP患者进行回顾性分析.结果 178例患者中位年龄41岁;按新分期标准,在可评价分期的175例患者中,新诊断ITP 87例(49.7%),持续性ITP 30例(17.1%),慢性ITP58例(33.1%);其中可评估疗效者167例,有效率分别为77.4%(65/84)、64.0%(16/25)、62.1%(36/58),完全缓解率分别为57.1%(48/84)、36.0%(9/25)、32.8%(19/58);新诊断ITP组的有效率及完全缓解率均显著高于慢性ITP组(x2=3.917,P＜0.05;x2=8.186,P＜0.01);大剂量地塞米松治疗组与泼尼松治疗组在性别、年龄、治疗前血小板计数等方面差异均无统计学意义,两种治疗方案近、远期有效率及完全缓解率差异无统计学意义而前者的起效时间显著短于后者(F=10.34,P＜0.01),且副作用小.结论 新的分期标准规范科学.大剂量地塞米松冲击治疗可作为首选治疗方案.     

Interferon therapy for patients more than 60 years of age with chronic hepatitis C

Abstract Nineteen patients aged > 60 years with chronic hepatitis C (CHC) received interferon (IFN) therapy and a complete response (CR) was achieved by five of them (26%). The incidence of CH with severe fibrosis in this elderly group was significantly higher than in another 52 patients with CHC who were < 60 years of age (the younger group; P < 0.05). There was no significant difference in the hepatitis C virus (HCV) genotype distribution between the elderly group and the younger group. However, the HCV-RNA titre was significantly higher in the elderly group than in the younger group ( P < 0.05). There was no significant difference in the efficacy rate of IFN in the elderly and younger groups after standardization of the background factors. In the elderly group, the HCV-RNA titre was significantly lower in the patients achieving CR than in those with no response ( P < 0.05). These data suggest that elderly patients with a low HCV-RNA titre can still respond well to IFN therapy.     

早期分化抗原在急性白血病中的表达及其意义

目的　探讨CD3 4 、CD90 及CD13 3 在急性白血病 (AL)中的表达及其意义。方法　采用三色直接免疫荧光法测定 76例AL患者白血病细胞膜上CD3 4 、CD90 及CD13 3 抗原的表达 ,半定量RT PCR方法测定CD13 3 mRNA的表达。结果　 (1)AL患者的CD3 4 及CD13 3 表达高于正常对照组(46 37%、0 4 7% )、(2 1 93%、0 2 9% ) ,P值均 <0 0 1;但CD90 的表达二者间差异无统计学意义(0 5 1%、0 2 5 % ) ,P >0 0 5 ;AL、对照组的CD13 3 抗原表达均与CD13 3 mRNA表达相一致。 (2 )急性淋巴细胞白血病 (ALL)的CD90 阳性率高于急性髓细胞白血病 (AML) (P <0 0 5 ) ,B ALL的CD3 4 阳性率高于T ALL(P <0 0 5 )。AML中M4的CD13 3 阳性率最高 (P <0 0 1)。 (3)CD3 4 及CD13 3 阳性组AL的HLA DR阳性率显著高于阴性组 (79 1%、32 0 % ;82 8%、4 6 2 % ) ,P值均 <0 0 1;CD 3 4 AML的CD13 3 阳性率高于阴性组 (P <0 0 1) ,但两组之间CD90 阳性率差异无统计学意义。 (4)CD3 4 、CD90 及CD13 3 表达与AL的细胞或分子遗传学异常等临床预后因素无明显关系。 (5 )CD3 4 、CD90 及CD13 3 阳性组的完全缓解率及总反应率低于阴性组 ,但仅有CD3 4 /CD13 3 双阳性组完全缓解率低于双阴性组差异有统计学意义 (P <0 0 5 )。结论