骨髓增殖性疾病患者的出血和血栓形成并发症

Hemorrhagic and thrombotic complications in patients with myeloproliferative diseases.

作者信息

Vignal C V, Lourenço D M, Noguti M A, Chauffaille M de L, Kerbauy J

机构信息

Department of Hematology, Universidade Federal de São Paulo, Brazil.

出版信息

Sao Paulo Med J. 1997 Nov-Dec;115(6):1575-9. doi: 10.1590/s1516-31801997000600004.

DOI:10.1590/s1516-31801997000600004

PMID:9640794

Abstract

OBJECTIVE

To correlate the incidence of hemorrhage and thrombosis to bleeding time (BT) and platelet aggregation in 27 consecutive patients with myeloproliferative diseases (MPD).

DESIGN

Retrospective study.

SETTING

Public tertiary referral center.

PATIENTS

Eighteen patients with chronic myelogenous leukemia (CML), 5 with polycytemia vera (PV), 2 with essential thrombocytemia (ET) and 2 with idiopathic myelofibrosis (MF). Duke's BT and epinephrine-induced platelet aggregation were performed on the patients and on 10 healthy individuals.

RESULTS

Eleven patients presented symptoms (41%):9 with hemorrhage (33%) and 5 with thrombosis (19%). There were less symptomatic patients in the CML group (28%) than in the other MPD (67%), without statistical significance (Fisher, p = 0.06). Duke's BT was longer in symptomatic patients (Mann-Whitney, p < 0.05). Platelet aggregation was abnormal in 7 patients (26%) and 71% of them were symptomatic (Fisher, p = 0.07).

CONCLUSIONS

The high incidence of bleeding and thrombosis in patients with MPD was related to prolonged BT, but not to platelet aggregation abnormalities.

摘要

目的

探讨27例骨髓增殖性疾病（MPD）患者出血和血栓形成的发生率与出血时间（BT）及血小板聚集之间的关系。

设计

回顾性研究。

地点

公立三级转诊中心。

患者

18例慢性粒细胞白血病（CML）患者、5例真性红细胞增多症（PV）患者、2例原发性血小板增多症（ET）患者和2例原发性骨髓纤维化（MF）患者。对这些患者及10名健康个体进行了杜克出血时间测定和肾上腺素诱导的血小板聚集试验。

结果

11例患者出现症状（41%）：9例出血（33%），5例血栓形成（19%）。CML组有症状的患者（28%）少于其他MPD组（67%），但无统计学意义（Fisher检验，p = 0.06）。有症状患者的杜克出血时间较长（Mann-Whitney检验，p < 0.05）。7例患者（26%）血小板聚集异常，其中71%有症状（Fisher检验，p = 0.07）。