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目的 探讨维甲酸和砷剂治疗急性早幼粒细胞白血病时D -二聚体的变化。方法 将 34例急性早幼粒细胞白血病患者随机分为两组 ,维甲酸组用维甲酸 (ATRA)治疗 40～ 6 0mg/d ;砷剂组 :复方血宁 (主要成分为As2 O3 ) 10ml/d ,2 8d 1疗程。每 7日查D -二聚体 1次 ,同时作凝血酶原时间、部分凝血活酶时间和纤维蛋白原检查 ,定期查血象、骨髓象。观察临床显性出血情况。结果 初治患者维甲酸组D -二聚体恢复至正常较砷剂组所需时间短 (P <0 0 5 ) ,复发患者维甲酸组D -二聚体恢复至正常较砷剂组所需时间长 (P <0 0 5 ) ,D -二聚体恢复至正常所需时间较凝血酶原时间、部分凝血活酶时间、纤维蛋白原均短 (P <0 0 5 )。结论 在维甲酸和砷剂治疗急性早幼粒细胞白血病过程中 ,D -二聚体作为反映止、凝血功能的指标比Fbg、PT、PTT敏感 ,初治病例 ,维甲酸组D -二聚体恢复比应用砷剂组快 ,复发病例 ,维甲酸组D -二聚体恢复比砷剂组慢。对指导治疗有一定意义。
Objective To investigate the changes of D - dimer in the treatment of acute promyelocytic leukemia with retinoic acid and arsenic. Methods A total of 34 patients with acute promyelocytic leukemia were randomly divided into two groups. The retinoic acid group was treated with ATRA 40 ~ 60mg / d, the arsenic agent group Fufangxuening (main component As2 O3) 10ml / d, 2 8d 1 course of treatment. Check D-dimer every seven days, at the same time for prothrombin time, partial thromboplastin time and fibrinogen check, regular check blood, bone marrow. Observe the clinical manifestations of bleeding. Results The time required for D - dimer to be restored to normal in AR patients after initial treatment was shorter than that in arsenic treated patients (P <0.05), and the D - dimer in RA patients returned to the normal For a long time (P <0.05), the time required for D - dimer to return to normal was shorter than that of prothrombin time, partial thromboplastin time and fibrinogen (P <0.05). Conclusions In the treatment of acute promyelocytic leukemia with retinoic acid and arsenic, D - dimer is more sensitive than Fbg, PT, PTT as an indicator of coagulation and coagulation function. In the newly diagnosed cases, D - dimer Compared with the arsenic treatment group, the D - dimer recovery in the retinoic acid group was slower than that in the arsenic treatment group. To guide the treatment of some significance.