摘要
目的研究儿童急性白血病患者凝血、抗凝及纤溶指标变化特点。方法以2013年1月至2016年12月浙江省丽水市中医院30例急性白血病患儿为观察组,观察组中急性髓系白血病(AML)患儿17例、急性淋巴细胞白血病(ALL)患儿13例,同期30例健康儿童为对照组;30例患儿根据有无出血分为出血组(18例)和未出血组(12例),比较研究对象凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体(DD)、纤维蛋白降解产物(FDP)的差异。结果对照组、ALL及AML三组凝血、抗凝及纤溶指标比较,PT、TT、DD、FDP均有统计学差异(F值分别为11.728、6.907、34.654、29.623,均P<0.05),APTT、Fib三组比较无统计学差异(P>0.05)。组间两两比较,AML患儿PT、TT延长,DD、FDP增高;ALL患儿TT延长,DD、FDP增高,差异均有统计学意义(q=2.78~27.32,均P<0.05)。出血组与未出血组凝血、抗凝及纤溶指标比较,出血组PT、TT均延长,DD、FDP均增高,组间差异有统计学意义(t=2.810~4.051,均P<0.05)。结论急性白血病患儿存在凝血、抗凝功能异常,继发性纤溶亢进,患儿存在出血风险,需要积极监测凝血功能变化。
Objective To study the changes of coagulation,anticoagulant and fibrinolytic indexes in children with acute leukemia.Methods Thirty children with acute leukemia admitted in Lishui Traditional Chinese Medicine Hospital of Zhejiang from January2013 to December 2016 were selected as observation group,including 17 cases of acute myeloid leukemia（AML）and 13 cases of acute lymphoblastic leukemia（ALL）.Thirty healthy children were chosen as control group at same period and were divided into bleeding group（18 cases）and non bleeding group（12 cases）based on bleeding conditions.Differences in prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fib）,D-dimer（DD）,and fibrin degradation products（FDP）in study objects were analyzed.Results Comparison of coagulation,anticoagulant and fibrinolytic indexes in control group,ALL group and AML group showed significant differences in PT,TT,DD and FDP（F value was 11.728,6.907,34.654 and 29.623,respectively,all P〈0.05）.There were no statistically significant differences in APTT and Fib among three groups（all P〈0.05）.Group comparison showed that PT and TT in AML patients and TT in ALL patients prolonged,and DD and FDP in both AML and ALL patients were increased with significant differences（q ranged 2.78-27.32,all P〈0.05）.Comparison of coagulation,anticoagulant and fibrinolytic indexes between bleeding group and non bleeding group showed that PT and TT prolonged and DD and FDP increased in bleeding group with significant differences（t value ranged 2.810-4.051,all P〈0.05）.Conclusion Children with acute leukemia suffer abnormal coagulation and anticoagulant function and secondary hyperfibrinolysis.There is risk of bleeding in patients.It is necessary to actively monitor changes in coagulation function.
出处
《中国妇幼健康研究》
2017年第12期1745-1747,共3页
Chinese Journal of Woman and Child Health Research
关键词
儿童
急性白血病
凝血
纤溶
children
acute leukemia
coagulation
fibrinolysis
