急性早幼粒细胞白血病患者止血和凝血分子标志物的检测分析

目的:检测急性早幼粒细胞白血病(APL)患者止血和凝血分子标志物含量变化及其临床意义。方法:采用ELISA方法检测46例APL患者于化疗前和完全缓解后的血浆血小板α颗粒膜糖蛋白-140(GMP-140)、D-二聚体(D-D)、凝血酶-抗凝血酶复合物(TAT)、凝血酶原片段F1+2、纤溶酶-抗纤溶酶复合物(PAP)含量,并与38例正常人对照。结果:化疗前46例APL患者血浆TAT、D-D、F1+2、GMP-140、PAP含量明显高于正常对照组(P<0.05~0.01),完全缓解后GMP-140、TAT、D-D、F1+2、PAP水平恢复正常;未缓解和复发患者GMP-140、TAT、D-D、F1+2、PAP水平与初诊患者无明显差异(P>0.05)。结论:APL患者凝血系统激活、纤溶亢进,但随病情好转可逐渐改善。止血和凝血分子标志物检测有助于APL病情和疗效观察。

Detection and Analysis of Molecular Markers of Blood Coagulation and Hemostasis in Acute Promyeloblastic Leukemia

Objective: To observe the changes of hemostatic and coagulative molecular markers in acute promyelocytic leukemia (APL), and explore the clinical significances.Method: The plasma levels of granulemembrane protein 140(GMP-140), D-Dimer(D-D), thrompin-antithrombin complex (TAT), prothrombin fragment 1+2(F_ 1+2 ) and plasmin-antiplasmin complex(PAP) of 46 patients with APL before chemotherapy and after complete remission(CR) and 38 normal controls were measured by ELISA.Results: The plasma levels of TAT, D-D, F_ 1+2 ,GMP-140 and PAP of 46 patients with APL before chemotherapy were all higher than those of nomal control(P<0.05～0.01). the level of GMP-140, TAT, D-D, F_ 1+2 and PAP recovered to nomal after complete remission. There were no significance differences between the non complete remission, relapse patients and preliminary diagnosis patients(P>0.05).Conclusion: The activation of coagulation system and hyperfibrinolysis in patients with APL can be ameliorated with clinical improvement. The detection of hemostatic and coagulative molecular markers can help to observe the state and curative effect of APL.