目的 研究急性白血病患者柔红霉素为主方案化疗前后血浆内皮细胞微粒(EMP)和组织因子微粒(TF+MP)水平变化.方法 2012年7月至2013年2月北京协和医院血液内科共15例初诊急性白血病患者接受DA(柔红霉素+阿糖胞苷)方案或VDCLP(长春新碱+柔红霉素+环磷酰胺+左旋门冬酰胺酶+泼尼松)方案化疗;其中女性7例,男性8例,中位年龄44岁;急性髓系白血病M01例,M11例,M29例,急性淋巴细胞白血病4例.于诱导化疗前和柔红霉素连续给药3 d后采集外周静脉血8 ml;通过流式细胞术检测血浆EMP和TF+MP水平.结果 柔红霉素给药3 d后患者血浆中位EMP和TF+MP水平高于诱导化疗前(28.94个/μl比10.74个/μl,P=0.001;64.24个/μl比43.80个/μl,P=0.02).结论 以柔红霉素为主的化疗方案可提高急性白血病患者血浆EMP和TF+MP水平.%Objective To observe the serum levels of endothelial microparticles (EMP) and tissue factor-bearing microparticles (TF+MP) in patients with acute leukemia before and after daunorubicin-based chemotherapy. Methods From July 2012 to February 2013, 15 patients with newly diagnosed acute leukemia in Peking Union Medical College Hospital received DA (daunorubicin + cytarabine) regimen or VDCLP (vincristine + daunorubicin + cyclophosphamide + L-asparaginase + prednisone) regimen chemotherapy. There were 8 males and 7 females, and the median age of patients was 44 years old. Eleven patients were acute myeloid leukemia (M01 case, M11 case, M29 cases), and 4 were acute lymphocytic leukemia. The peripheral blood samples were taken before induction chemotherapy and after 3 days of daunorubicin. Levels of EMP and TF+MP were assessed using flow cytometry. Results The serum EMP and TF+MP levels were significantly higher after 3-day daunorubicin infusions than those before induction chemotherapy (28.94/μl vs. 10.74/μl, P= 0.001; 64.24/μl vs. 43.80/μl, P= 0.02). Conclusion Daunorubicin-based chemotherapy may cause increased numbers of EMP and TF+MP in patients with acute leukemia.
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