组织因子及组织因子微粒在急性髓系白血病中的检测及临床意义

白斯君; 杨林花; 董春霞; 郭志萍; 葛晓燕; 康建民; 张建华; 任方刚; 张耀芳; 侯彦飞; 杨晨

组织因子及组织因子微粒在急性髓系白血病中的检测及临床意义

- 山西医科大学第二医院血液科(太原, 030001)
基金项目:
卫生公益性行业科研专项（No：201202017）

详细信息

通讯作者: 杨林花,E-mail:yanglh5282@163.com

中图分类号: R733.71

收稿日期: 2013-05-18

Detection and clinical significance of tissue factor and microparticle-associated tissue factor in acute myeloid leukemia

- Department of Hematology, the Second Hospital of Shanxi Medical University, Taiyuan, 030001, China

More Information

Corresponding author: YANG Linhua, E-mail: yanglh5282@163.com

Received Date: 18 May 2013

摘要

摘要: 目的：通过检测急性髓系白血病（AML）患者血浆中组因子（TF）及组织因子微粒（MP-TF）的表达，探讨其在AML凝血异常中的临床意义。方法：选择AML住院患者64例（AML组），其中急性早幼粒细胞白血病（APL）22例，非APL 42例；并发弥散性血管内凝血（DIC）22例，未并发DIC 42例。非APL中13例治疗后骨髓完全缓解（CR），APL中15例治疗后骨髓达CR，包含12例APL并发DIC患者。对照组34例均为健康献血员。采用流式细胞术检测MP-TF，ELISA法检测血浆中TF。结果：治疗前AML组MP-TF及TF水平明显高于对照组[（60.90±14.90）%：（45.80±12.03）%，P<0.01；（129.11±37.32）pg/ml：（95.96±19.56）pg/ml，P<0.05]。AML组内，15例治疗后骨髓达CR的APL患者治疗前后MP-TF水平差异有统计学意义[（60.13±8.95）%：（51.65±8.11）%，P<0.05]，其中12例APL并发DIC患者治疗前MP-TF及TF水平均高于治疗后[（60.00±9.45）%：（56.70±17.10）%；（155.67±31.14）pg/ml：（122.03±18.41）pg/ml，均P<0.05]；13例治疗后骨髓达CR的非APL患者治疗前TF明显高于治疗后[（147.61±27.43）pg/ml：（118.73±20.23）pg/ml，P<0.01]。AML组内，凝血酶原时间（PT）延长>3 s的患者（10例）MP-TF水平明显高于PT延长<3 s及PT正常的患者（54例）[（64.10±9.38）%：（59.40±19.73）%，P<0.05]；纤维蛋白降解产物（FDP）异常的患者（24例）TF水平明显高于FDP正常患者（40例）[（152.26±37.89）pg/ml：（112.81±35.47）pg/ml，P<0.05]。结论：MP-TF及TF是参与凝血异常的重要指标，MP-TF较血浆TF能更好地反映TF活性水平，且MP-TF与AML尤其是APL及其凝血异常有密切关系，可作为监测APL疾病病情缓解的有效指标之一。
- 急性髓系白血病 /
- 组织因子微粒 /
- 急性早幼粒细胞白血病 /
- 弥散性血管内凝血
Abstract: Objective: To detect and explore the clinical significance of tissue factor (TF) and microparticle-associated tissue factor (MP-TF) in acute myeloid leukemia (AML) patients.Method: The peripheral blood in 64 cases of AML with newly diagnosed was collected,including 22 cases of APL,42 cases of non-APL,and 22 cases of AML with DIC and 42 cases of AML without DIC.Thirteen cases of non-APL with bone marrow complete remission (CR),15 cases of APL with bone marrow CR including 12 cases of APL with DIC.Thirty-four cases of normal controls were healthy blood donors.MP-TF was detected by FCM and TF was detected by ELISA.Result: MP-TF and TF in AML patients were both higher than those in the normal controls (P<0.01,P<0.05).MP-TF in the 15 cases of APL with bone marrow CR was higher before chemotherapy than that after chemotherapy (P<0.05).The levels of MP-TF and TF in 12 cases of APL with DIC were higher before chemotherapy than those after chemotherapy (P<0.05).TF in the 13 cases of non-APL with bone marrow CR was higher before chemotherapy than that after chemotherapy (P<0.01).The MP-TF in the patients with PT>3 s was higher than that with normal PT value (P<0.05).TF in the patients with abnormal FDP value was increased than that with normal FDP (P<0.05).Conclusion: MP-TF and TF are important indicators involved in coagulopathy,and MP-TF could better reflect the activity of TF.MP-TF is associated with haemostatic dysfunction in the AML,and it could be used as a factor to monitor disease remission.
- acute myeloid leukemia /
- microparticle-associated tissue factor /
- acute promyelocytic leukemia /
- disseminated intravascular coagulation

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