摘要
目的 探讨急性白血病 (AL)患者颅内出血 (ICH)相关因素 ,以便采取相应的预防措施 ,降低其病死率。方法 回顾分析我院血液科 1989年 12月至 2 0 0 2年 8月发生ICH的AL患者 16 1例 (ICH组 )的临床和实验室资料 ,并随机抽取同期住院的无ICH的AL患者 16 9例为对照组 (非ICH组 )。结果 ICH最多见于慢性粒细胞性白血病(CML)急变期患者 (13.89% ) ,其次为急性单核细胞性白血病 (M5) (9.79% )和急性早幼粒细胞白血病 (M3 ) (9.17% )患者 ,急性髓细胞性白血病比急性淋巴细胞白血病容易发生ICH。ICH与血小板减少、低血红蛋白水平、疾病病程、合并感染和高白细胞计数等密切相关 ;头颈部出血往往是ICH的先兆。ICH的Logistic回归结果表明 ,ICH的几率随着白细胞 (WBC)的增高而上升 ,随血小板 (Plt)的上升而下降。WBC每增加 1个单位 ,ICH的几率就增加大约 0 .6 % ;Plt每增加 1个单位 ,颅内出血的几率就减少大约 0 .8%。结论 ICH与严重的血小板减少、高白细胞计数密切相关 ,如这些患者出现头颈部出血预示ICH即将发生 ,应及时采取相应干预措施预防ICH。
Objective To investigate the relationship between acute leukemia(AL) and intracranial hemorrhage(ICH),and use active therapeutic measure to lower the mortality of ICH patients.Methods The data of 161 ICH patients with AL were retrospectively analyzed from Dec 1989 to Aug 2002 and 169 AL patients in the same period without ICH chosen as control group.Results The patients who were in blast crisis of chronic myeloid leukemia had the highest incidence of ICH,whose rates were 13.89%,followed by 9.79% in acute monocytic leukemia(M 5), 9.17% in acute pronyelocytic leukemia(M 3) respectively.Acute myeloid leukemia patients were more susceptible to ICH than acute lymphoblastic leukemia patients.ICH related to thrombocytopenia,lower hemoglobin,disease course,infection,and high white blood cell count.The upper trunk′s bleeding may foretell the possibility of ICH.The result of Logistic regression implied that the incidence of ICH was related to platelet and white blood cell(WBC) (P< 0.0001),the incidence of ICH might increase 0.6%,when WBC increases 1 unit (1×109/L),the incidence of ICH might decrease 0.8% when platelet increases 1 unit (1×109/L).Conclusion ICH is closely related to the leukocytosis and severe thrombocytopenia.The hemorrhage in the skin and mucous membrane of head and neck is a portent forthcoming ICH,so the patients should be treated on time to avoid ICH.
出处
《临床荟萃》
CAS
北大核心
2005年第4期187-189,共3页
Clinical Focus
关键词
白血病
淋巴细胞
急性
血细胞计数
脑出血
因素分析
统计学
leukemia,lymphocytic,acute
blood cell count
cerebral hemorrhage
factor analysis,statistical
