恶性血液病患者化疗后出血与血小板计数和白细胞计数的关系

发布时间：2018-06-01 13:18

本文选题：恶性血液病 + 出血　；参考：《中国输血杂志》2017年01期

【摘要】：目的探讨恶性血液病患者化疗后出血的与白细胞和血小板计数的关系。方法观察96例恶性血液病化疗后的临床出血情况,监测出血时血小板计数、化疗前白细胞计数。比较不同年龄组、性别、疾病缓解状态的出血发生率;分析出血程度与血小板减少程度、白细胞计数的关系。结果 96例恶性血液病患者化疗后出血28例(ALL4例,AML(非M3型)16例,NHL1例,MM2例,HL1例,MDS4例),出血发生率为29.2%;≥55岁组出血发生率为44.2%(23/52),明显高于55岁组(11.4%,5/44)(χ~2=12.462,P0.05),而不同性别患者化疗后出血发生率的差异无统计学意义(P0.05)。缓解组患者化疗后出血发生率为15.21%;未缓解组患者出血发生率为42.0%,较缓解组患者出血发生率高(χ~2=8.318,P0.05)。出血患者均有血小板减少,1-2级出血组和3-4级出血组患者的血小板减少程度的差异有统计学意义(χ~2=13.38,P0.01)。白细胞计数≥50×109/L的急性白血病患者出血患者3-4级的出血发生率高于白细胞计数50×109/L的患者,差异有统计学意义(χ~2=6.806,P0.05)。结论年龄≥55岁、恶性血液病未缓解可能为出血的危险因素;白细胞计数≥50×109/L可能为急性白血病患者3-4级出血的危险因素;血小板减少与恶性血液病患者出血相关,血小板20×109/L时出血发生率明显增加。
[Abstract]:Objective to investigate the relationship between leukocyte and platelet count after chemotherapy in patients with malignant hematopathy. Methods to observe the clinical bleeding of 96 patients with malignant hematopathy after chemotherapy, to monitor the blood platelet count and the white blood cell count before chemotherapy, to compare the incidence of bleeding in different age groups, sex, and disease remission state, and to analyze the degree of bleeding and the degree of bleeding. Results of 96 cases of malignant hematopathy, 28 cases of hemorrhage after chemotherapy (ALL4, AML (non M3), NHL1, MM2, HL1, MDS4), the incidence of hemorrhage was 29.2%, and the incidence of hemorrhage in 55 years old was 44.2% (23/52), obviously higher than that of 55 year group (11.4%, 5/44) (chi ~2=12.462, P0.05), and patients of different sex There was no significant difference in the incidence of hemorrhage after chemotherapy (P0.05). The incidence of post chemotherapy bleeding was 15.21% in the remission group, 42% in the non remission group and higher in the relief group than in the remission group (x ~2=8.318, P0.05). The thrombocytopenia in the bleeding patients, the 1-2 stage bleeding group and the 3-4 stage hemorrhage group were reduced. The difference in degree was statistically significant (x ~2=13.38, P0.01). The incidence of bleeding in patients with acute leukemia with leukocyte count more than 50 * 109/L was higher than that of leukocyte count 50 x 109/L, the difference was statistically significant (x ~2=6.806, P0.05). Conclusion the age of 55 years old, malignant hematopathy may be a risk factor for bleeding. The cell count of more than 50 * 109/L may be a risk factor for stage 3-4 hemorrhage in acute leukemia, and thrombocytopenia is associated with hemorrhage in patients with malignant hematopathy, and the incidence of hemorrhage at 20 * 109/L of platelets is significantly increased.
【作者单位】：徐州医学院第二附属医院;
【分类号】：R733

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