急性白血病患者血浆 ecy、AT - III 及 vWF 的检测及其临床意义

摘要

目的：检测急性白血病（acute leukemia，AL）患者不同发展阶段血浆同型半胱氨酸（ homocysteine， ecy）、抗凝血酶Ⅲ（antithrombin III）、血管性血友病因子（von willebrand factor，vWF）水平，探讨这些活性物质在 AL 的诊断、治疗及预后判断中的临床意义。方法：选择初诊 AL 患者40例，正常对照30例。测定其血浆ecy、AT - III 及 vWF 水平，并对 AL 患者进行治疗前、后不同阶段的动态检测。骨髓涂片在显微镜下按常规分类计数200个有核细胞，计算原始加幼稚细胞比例。结果：AL 组初诊时血浆 vWF 含量明显升高，与正常对照组比较有显著性差异（P ﹤0.01）。AL 组初诊时血浆 AT - III 含量明显减低，与正常对照组比较差异有统计学意义（P ﹤0.05）。AL 组初诊时血浆 ecy 含量明显升高，与正常对照组比较有显著性差异（ P ﹤0.01）。经过2-3个疗程的治疗后，达到完全缓解（CR）时，血浆 ecy、AT -Ⅲ及 vWF 含量恢复正常，与正常对照组比较无显著差异（P ﹥0.05）。经过2-3个疗程的治疗后，未达到缓解[包括部分缓解（PR）和未缓解（NR）]时，上述因子与治疗前比较差异无统计学意义（P ﹥0.05）；AL 初诊患者治疗前血浆 vWF 及 ecy 水平与骨髓原始加幼稚细胞数呈正相关（P ﹤0.001和 P ﹤0.01），而 AT -Ⅲ水平与骨髓原始加幼稚细胞数呈负相关（P ﹤0.05，r ＝-0.622）。结论：动态监测 AL 患者血浆 ecy、AT - III 及 vWF 水平，可作为白血病病情进展、疗效过程及判断预后的重要参考指标。%Objective:To measure the levels of Plasma homocysteine,antithrombin III and von willebrand factor in different Phrases of Patients with acute leukemia,and to exPlore their significance in the diagnosis and clinical theraPy of acute leukemia. Methods:The vWF,AT - III and ecy of 40 acute leukemia Patients and thirty health adult were detected,the results were analyzed in different Phrases. The nuclear cells were counted in bone marrow smear in 40 cases of acute leukemia Patients. Results:ComPared with normal control grouP,Plasma level of vWF was elevated be-fore treatment in acute leukemia Patients(P ﹤ 0. 01). ComPared with normal control grouP,Plasma level of AT - III was decreased before treatment in acute leukemia Patients(P ﹤ 0. 05). ComPared with normal control grouP,Plasma level of ecy was elevated before treatment in acute leukemia Patients( P ﹤ 0. 01). ComPared with normal control grouP,the vWF,AT - III and ecy had no difference in acute leukemia after comPlete remission(CR)(P ﹥ 0. 05). ComPared with AL Patients before treatment,vWF,AT - III and ecy had also no difference in acute leukemia after non - remission(NR)(P ﹥ 0. 05). There was Positive correlation between the total number of Primary and naive cells and vWF,ecy in acute leukemia(P ﹤ 0. 001 and P ﹤ 0. 01). And there was negative correlation between the total number of Primary and naive cells and AT - III in acute leukemia(P ﹤ 0. 05,r = - 0. 622). Conclusion:Monitoring in different Prase the content of Plasma vWF,AT - III and ecy in acute leukemia Provided the evidence for early diag-nosis Prevention and cure of acute leukemia.