CAJ | 학술논문

目的：探讨凝血检查在判断早幼粒细胞白血病合并DIC患者中的临床意义。方法合并DIC的早幼粒细胞白血病患者用维甲酸或合并亚砷酸诱导缓解治疗，动态测定凝血酶原时间（ PT）、激活部分凝血活酶时间（ aPTT）、凝血酶时间（TT）、血浆纤维蛋白原（Fbg）、抗凝血酶（AT）、D二聚体（D-D）和纤维蛋白降解产物（FDP）。结果17例患者中，15例合并DIC。其中15例患者均在35天内获得完全缓解。 PT、Fbg、D-D和FDP均明显异常，与临床出血症状、DIC相关；aPTT、TT和AT均在正常范围内波动。结论动态观察血浆Fbg、D-D和FDP有助于判断DIC存在与严重程度，Fbg水平对指导血制品输注更有意义。
목적：탐토응혈검사재판단조유립세포백혈병합병DIC환자중적림상의의。방법합병DIC적조유립세포백혈병환자용유갑산혹합병아신산유도완해치료，동태측정응혈매원시간（ PT）、격활부분응혈활매시간（ aPTT）、응혈매시간（TT）、혈장섬유단백원（Fbg）、항응혈매（AT）、D이취체（D-D）화섬유단백강해산물（FDP）。결과17례환자중，15례합병DIC。기중15례환자균재35천내획득완전완해。 PT、Fbg、D-D화FDP균명현이상，여림상출혈증상、DIC상관；aPTT、TT화AT균재정상범위내파동。결론동태관찰혈장Fbg、D-D화FDP유조우판단DIC존재여엄중정도，Fbg수평대지도혈제품수주경유의의。
Objective To explore clinical significance of coagulation parameter in acute promyelocytic leukemia complicated with DIC .Methods 17 cases with acute promyelocytic leukemia were treated with all-trans retinoic acid solely or plus arsenic trioxide .Dynamic detection of coagulation profiles were conducted . Results 17 cases were diagnosis as de novo acute promyelocytic leukemia , and 15 cases were complicated with DIC.A total of 15 cases achieved complete remission within 35 days.Dynamic observation showed that prothrombin time ,serum fibrinogen , D-dimer and fibrin degradation product were significantly out of normal value at interval of induction treatment .These parameters were associated with clinical hemorrhage and DIC manifestations .Serum fibrinogen level was more helpful in guiding transfusion of blood products .Activated partial thromboplastin time ,thrombin time , and antithrombin were fluctuated at normal range .Conclusion Dynamic observation on fibrinogen ,D-dimer and fibrin degradation product may contribute to DIC diagnosis and severity evaluation .Serum fibrinogen can be used as an indicator for guiding transfusion of blood products .