急性白血病与弥散性血管内凝血

目的分析急性白血病（AL）患者弥散性血管内凝血（DIC）的发生情况，凝血功能改变及其临床意义。方法对67例AL患者、25例AL完全缓解（CR）患者、20例健康体检者进行凝血常规、D-二聚体等检测。结果根据ISTH修订标准，15例AL患者合并DIC，发生率为22．4％，AML与ALL的DIC发生率AML-M3之间无统计学差异（P〉0．05），AML-M3与non-AML-M3的DIC的发生率之间有统计学差异（P〈0．05）。DIC组PT、APTT、TT较对照组、CR组及non-DIC组均明显延长（P〈0．01），而FIB则降低（P〈0．05）。结论AL尤其AML-M3患者容易合并DIC，观察患者凝血功能改变以及出血表现可有助于尽早发现DIC并指导临床预防及治疗，从而有利于改善AL合并DIC患者的临床预后。

Acute leukemia and disseminated intravascular coagulation

ObJecflve To analyze the development of disseminated iniravascular coagulation and alteration of coagnlation function indexes in acute leukemia patients and evaluate its clinical significance.Methods 67 patients with acute leukemia were studied,compared with 25 complete remission patients with acute leukemia and 20 healthy exsminers.Coagulation routine and D-dimer were detected.Results Patients with acute leukemia 15 patients(22.4%)had DIC by the modified ISTH criteria at presentation.There was no significant difference between AML group and ALL group(P＞0.05),but there was significant difference between AML-M,group and non-AML-M3 group(P＜0.05).As compared with control group、CR group and non-DIC group,the leveIs of PT、AFIT、TT were significant higher(P＜0.01),and the levels of FIB was lower(P＜0.05).Conclusion The patients with acute leukemia especially AML-M3 may be complicated with DIC easily.According to the abnormalitiy of coagulation function and bleeding manifestation,not only can reach a prompt diagnosis of DIC,but also can give patients clinical precaution and treatment,so to improve the prognosis of acute leukemia patients with DIC.