急性白血病患者血管性血友病因子抗原检测的临床价值

摘要

Objective:To explore the clinical meaning of von willebrand factor antigen(vWF:Ag) detection in patients with acute leukemia. Methods:The levels of vWF:Ag,D-dimer and fibrin/fibrinogen degradation products(FDPs) were detected by CA-7000 coagulation analyzer,the levels of lactate dehydrogenase( LDH) and high sensitive C-reactive protein( hs-CRP) were detected by 7600 automated biochemistry analyzer,the complete blood counts were tested by Mindray 6 800 hematology analyzer in 39 patients with acute leukemia(including 15 cases with WBC>50 í109/L and 24 cases with <50 í109/L) and 21 normal controls. Results:Compared with the control group,the levels of vWF:Ag,D-dimer,FDPs,LDH and hs-CRP were higher in acute leukemia patients(P<0. 01),the levels of vWF:Ag and LDH were higher in acute leukemia patients with WBC>50í109/L than those with WBC<50í109/L( P<0. 05 and P<0. 01),vWF:Ag had the positive correlations with D-dimer,FDPs,LDH and hs-CRP. Conclusions:The endothelial cell injury was happened in patients with acute leukemia,which presented as the increase of vWF:Ag,the manifestation was correlated with tumor load,acute phase response and hyperfibrinolysis.%目的：初步探讨急性白血病( AL)患者血管性血友病因子抗原( vWF：Ag)检测的临床意义。方法：39例AL患者( AL组),外周血白细胞计数>50×109/L 15例,<50×109/L 24例,21名健康体检者为正常对照组(对照组)。使用CA-7000血凝仪检测vWF：Ag、D-二聚体及纤维蛋白(原)降解产物( FDPs)；使用7600型生化分析仪检测乳酸脱氢酶( LDH)和超敏C反应蛋白( hs-CRP)；全血细胞计数采用迈瑞6800型血细胞分析仪。结果：AL组的vWF：Ag、D-二聚体、FDPs、LDH和hs-CRP水平均明显高于对照组(P<0.01)；白细胞>50×109/L的患者vWF：Ag和LDH均高于白细胞<50×109/L的患者(P<0.05和P<0.01),vWF：Ag与D-二聚体、FDPs、LDH和hs-CRP水平均呈正相关关系(P<0.05)。结论：AL患者存在以vWF：Ag升高为表现的内皮细胞损伤,这种表现与肿瘤负荷、急性期反应和纤溶亢进有关。