急性非淋巴细胞白血病中血液凝固和纤维蛋白溶解的因素及抑制剂

Factors and inhibitors of blood coagulation and fibrinolysis in acute nonlymphoblastic leukaemia.

作者信息

Bratt G, Blombäck M, Paul C, Schulman S, Törnebohm E, Lockner D

出版信息

Scand J Haematol. 1985 Apr;34(4):332-9. doi: 10.1111/j.1600-0609.1985.tb00758.x.

DOI:10.1111/j.1600-0609.1985.tb00758.x

Abstract

Factors of coagulation and fibrinolysis have been evaluated in 15 patients with untreated acute nonlymphoblastic leukaemia (ANLL). 10 patients had major bleeding (MB) and 6 had laboratory signs of DIC. 5 patients went into complete remission (CR). Antithrombin III (AT III) was decreased in 7 patients, antiplasmin (AP) in 9, fibronectin (FN) in 6 and factor XIII in 4/12. The ratio between factor VIIIR:Ag and factor VIII:C was over 2.0 in 11 patients, and high values were especially seen in patients with MB and patients with DIC. Spontaneous proteolytic activity, measured with S-2288 was increased in 3 patients who all had MB, and none of whom achieved CR. 2 patients with promyelocytic leukaemia (M3) had low fibrinogen and AP, high FDP and normal AT III, speaking for primary fibrinolysis, which in addition to proteolytic enzymes in the blast cells are important contributing factors regarding MB in ANLL.

摘要

对15例未经治疗的急性非淋巴细胞白血病（ANLL）患者的凝血和纤溶因子进行了评估。10例患者有严重出血（MB），6例有弥散性血管内凝血（DIC）的实验室指标。5例患者达到完全缓解（CR）。7例患者抗凝血酶III（AT III）降低，9例抗纤溶酶（AP）降低，6例纤连蛋白（FN）降低，12例中有4例因子XIII降低。11例患者中因子VIII相关抗原（factor VIIIR:Ag）与因子VIII:C的比值超过2.0，在有MB的患者和有DIC的患者中尤其可见高值。用S-2288测定的自发蛋白水解活性在3例均有MB且无一例达到CR的患者中升高。2例早幼粒细胞白血病（M3）患者纤维蛋白原和AP低，纤维蛋白降解产物（FDP）高，AT III正常，提示原发性纤溶，除了原始细胞中的蛋白水解酶外，这也是ANLL中MB的重要促成因素。